The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Research Helps Explain Idiosyncrasies of COVID-19

Research Helps Explain Idiosyncrasies of COVID-19

November 23, 2021 • By Jason Liebowitz, MD

  • Tweet
  • Email
Print-Friendly Version / Save PDF

ACR CONVERGENCE 2021—So many elements of the past two years have been, to put it mildly, unusual given the effects of the COVID-19 pandemic. Perhaps equally strange have been the discoveries related to understanding how the SARS-CoV-2 virus functions, what leads to mild or severe disease in different patients and what implications these findings hold for the field of rheumatology. Mariana Kaplan, MD, chief of the Systemic Autoimmunity Branch of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Medicine (NIH), Bethesda, Md., moderated Day 2 of the Basic and Clinical Research Conference focused on Rheumatology Complications of Emerging Viral Infections/SARS-CoV-2.

You Might Also Like
  • ACR Releases COVID-19 Clinical Guidance for Pediatric Patients
  • The Many Facets of COVID-19: Experts Address Basic & Clinical Research Concepts in the COVID-19 Era
  • After COVID-19-Associated MIS-C, Immune Changes Resolve
Also By This Author
  • Untangling the Diagnosis & Management of GCA

Pathophysiology of COVID-19

The featured speaker in the session was Dennis McGonagle, FRCPI, PhD, head of experimental rheumatology at the Leeds Institute of Rheumatic and Musculoskeletal Medicine, St. James Hospital, University of Leeds, U.K. Dr. McGonagle discussed the distinctive form of pulmonary immunovascular thrombosis that is seen with COVID-19 disease and how the pathophysiology of disease has come to be understood over time.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

He pointed first to a letter to the editor published in The Lancet on March 16, 2020, that has since been cited over 6,000 times. In the correspondence, Mehta and colleagues noted how treatments for COVID-19 had been focused on antiviral therapy and supportive care, but that hyperinflammation seems to play a large role in severe disease and, thus, immunosuppression should be considered as part of the treatment regimen for this cytokine storm-like entity.1

Indeed, Mehta et al. referenced a retrospective, multi-center study of 150 confirmed COVID-19 cases in Wuhan, China, that indicated how elevated ferritin and interleukin-6 (IL-6) levels were predictors of increased mortality, thereby implying that virally driven hyperinflammation may significantly contribute to the risk of death.2 This hypothesis subsequently led to the use of corticosteroids and IL-6 inhibition with medications like tocilizumab as part of the treatment of COVID-19.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Dr. McGonagle acknowledged that entities like cytokine release syndrome in macrophage activation syndrome (MAS) or in cases of chimeric antigen receptor (CAR)-T cell therapy appear similar to the forms of organ failure seen with severe COVID-19, but he identified discrepancies in the lab results seen in these conditions. For instance, severe cytokine storm will generally demonstrate IL-6 levels up to 10,000 pg/ml and ferritin levels close to 100,000 μg/L. In studies looking at these biomarkers in COVID-19, levels appear much lower, with IL-6 levels in severe COVID-19 disease reaching only 10% of the usual elevation seen with cytokine release syndrome associated with CAR-T cell therapy.

Pages: 1 2 3 4 5 6 7 | Single Page

Filed Under: ACR Convergence, Meeting Reports Tagged With: ACR Convergence 2021, COVID-19, interferon, Multisystem Inflammatory Syndrome in Children (MIS-C)

You Might Also Like:
  • ACR Releases COVID-19 Clinical Guidance for Pediatric Patients
  • The Many Facets of COVID-19: Experts Address Basic & Clinical Research Concepts in the COVID-19 Era
  • After COVID-19-Associated MIS-C, Immune Changes Resolve
  • Jury Out on Immunomodulatory Therapy for Kids with Severe COVID-19

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2022 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.