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Risk and management of patients with mastocytosis and MCAS in the SARS-CoV-2 (COVID-19) pandemic: Expert opinions.
Journal of Allergy and Clinical Immunology ( IF 14.2 ) Pub Date : 2020-06-17 , DOI: 10.1016/j.jaci.2020.06.009
Peter Valent 1 , Cem Akin 2 , Patrizia Bonadonna 3 , Knut Brockow 4 , Marek Niedoszytko 5 , Boguslaw Nedoszytko 6 , Joseph H Butterfield 7 , Ivan Alvarez-Twose 8 , Karl Sotlar 9 , Juliana Schwaab 10 , Mohamad Jawhar 10 , Andreas Reiter 10 , Mariana Castells 11 , Wolfgang R Sperr 1 , Hanneke C Kluin-Nelemans 12 , Olivier Hermine 13 , Jason Gotlib 14 , Roberta Zanotti 15 , Sigurd Broesby-Olsen 16 , Hans-Peter Horny 17 , Massimo Triggiani 18 , Frank Siebenhaar 19 , Alberto Orfao 20 , Dean D Metcalfe 21 , Michel Arock 22 , Karin Hartmann 23
Affiliation  

The coronavirus disease 2019 (COVID-19) (caused by severe acute respiratory syndrome coronavirus 2) pandemic has massively distorted our health care systems and caused catastrophic consequences in our affected communities. The number of victims continues to increase, and patients at risk can only be protected to a degree, because the virulent state may be asymptomatic. Risk factors concerning COVID-19–induced morbidity and mortality include advanced age, an impaired immune system, cardiovascular or pulmonary diseases, obesity, diabetes mellitus, and cancer treated with chemotherapy. Here, we discuss the risk and impact of COVID-19 in patients with mastocytosis and mast cell activation syndromes. Because no published data are yet available, expert opinions are, by necessity, based on case experience and reports from patients. Although the overall risk to acquire the severe acute respiratory syndrome coronavirus 2 may not be elevated in mast cell disease, certain conditions may increase the risk of infected patients to develop severe COVID-19. These factors include certain comorbidities, mast cell activation–related events affecting the cardiovascular or bronchopulmonary system, and chemotherapy or immunosuppressive drugs. Therefore, such treatments should be carefully evaluated on a case-by-case basis during a COVID-19 infection. In contrast, other therapies, such as anti–mediator-type drugs, venom immunotherapy, or vitamin D, should be continued. Overall, patients with mast cell disorders should follow the general and local guidelines in the COVID-19 pandemic and advice from their medical provider.



中文翻译:

SARS-CoV-2 (COVID-19) 大流行中肥大细胞增多症和 MCAS 患者的风险和管理:专家意见。

2019 年冠状病毒病 (COVID-19)(由严重急性呼吸综合征冠状病毒 2 引起)大流行严重扭曲了我们的医疗保健系统,并给受影响的社区造成了灾难性后果。受害者人数不断增加,处于危险中的患者只能得到一定程度的保护,因为毒力状态可能是无症状的。与 COVID-19 相关的发病率和死亡率的危险因素包括高龄、免疫系统受损、心血管或肺部疾病、肥胖、糖尿病和化疗癌症。在这里,我们讨论 COVID-19 对肥大细胞增多症和肥大细胞激活综合征患者的风险和影响。由于尚无公开数据,专家意见必然基于病例经验和患者报告。尽管肥大细胞病中感染严重急性呼吸综合征冠状病毒 2 型的总体风险可能不会升高,但某些情况可能会增加感染患者发展为重症 COVID-19 的风险。这些因素包括某些合并症、影响心血管或支气管肺系统的肥大细胞激活相关事件以及化疗或免疫抑制药物。因此,在感染 COVID-19 期间,应根据具体情况仔细评估此类治疗方法。相反,其他疗法,如抗介质类药物、毒液免疫疗法或维生素 D,应继续进行。总体而言,肥大细胞疾病患者应遵循 COVID-19 大流行的一般和当地指南以及医疗服务提供者的建议。

更新日期:2020-08-05
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