During the current global outbreak of coronavirus disease 2019 (COVID-19), risk stratification of patients is of utmost importance. Currently, patients >65 years and those with pre-existing medical conditions such as cardiovascular disease, chronic respiratory disease or diabetes mellitus are considered at higher risk for severe disease.1 The Swiss Federal Office of Public Health, like similar authorities around the world, has additionally included patients on immunosuppressants in the high-risk group for developing severe COVID-19.2 However, at this moment we do not have enough evidence either to support or to reject this assumption. We report the case of a 57-year-old woman with systemic sclerosis (SSc) who developed COVID-19. Comorbidities were insulin-dependent type 2 diabetes mellitus and WHO grade I obesity. The anti-topoisomerase I antibody-positive patient was diagnosed with SSc in 2017. SSc-associated interstitial lung disease (SSc-ILD), with cough and exertion dyspnoea, was the leading organ manifestation, associated with symmetrical, non-erosive polyarthritis, and elevated acute phase reactants. Treatment with the anti-interleukin (IL) 6 receptor blocker tocilizumab, with 8 mg/kg body weight every 4 weeks intravenously, was started, leading to a good control of both …

中文翻译：

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使用托珠单抗治疗 SSc-ILD 的系统性硬化症患者的 COVID-19

在当前全球爆发 2019 年冠状病毒病 (COVID-19) 期间，患者的风险分层至关重要。目前，超过 65 岁的患者以及患有心血管疾病、慢性呼吸系统疾病或糖尿病等疾病的患者被认为患严重疾病的风险较高。 1 瑞士联邦公共卫生办公室与世界各地的类似机构一样，还包括在高危组中使用免疫抑制剂的患者，以发展为严重的 COVID-19.2 然而，目前我们没有足够的证据来支持或拒绝这一假设。我们报告了一名患有系统性硬化症 (SSc) 的 57 岁女性感染 COVID-19 的病例。合并症为胰岛素依赖型 2 型糖尿病和 WHO I 级肥胖。抗拓扑异构酶 I 抗体阳性患者于 2017 年被诊断为 SSc。 SSc 相关间质性肺病 (SSc-ILD) 伴有咳嗽和劳力性呼吸困难，是主要器官表现，与对称性非糜烂性多关节炎相关，以及急性期反应物升高。开始使用抗白细胞介素 (IL) 6 受体阻滞剂托珠单抗治疗，每 4 周静脉注射 8 毫克/公斤体重，这导致了两者的良好控制……