ABSTRACT

Introduction

Main clinical manifestations of SARS-CoV-2 infection are characterized by fever, dyspnea, and interstitial pneumonia, frequently evolving in acute respiratory distress syndrome (ARDS).

Areas covered

Features of coronavirus disease 2019 (COVID-19) presents some common points with interstitial lung disease (ILD) both idiopathic and related to rheumatoid arthritis (RA), typically characterized by a chronic progression over time and possibly complicated by acute exacerbation (AE). The study of common pathogenetic mechanisms, such as the involvement of toll-like receptor 4, could contribute to the knowledge and treatment of idiopathic and RA-ILD. Moreover, hyperinflammation, mainly characterized by increase of effector T-cells and inflammatory cytokines, and activation of coagulation cascade, observed in COVID-19 related ARDS have been already shown in patients with AE of idiopathic and RA-ILD. A literature search was performed in PubMed, Embase, Scopus, and Web of Science, together with a manual search in COVID-resource centers of the main journals.

Expert opinion

Despite the uncertainty about pathogenetic aspects about COVID-19- pneumonia, it could be a possible model for other forms of ILD and AE. The great amount of data from studies on COVID-19 could be helpful in proposing safe therapeutic approaches for RA-ILD, in understanding pathogenesis of usual interstitial pneumonia and to develop new therapeutic strategies for AE.

中文翻译：

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特发性和类风湿性关节炎相关间质性肺炎的发病机制和治疗。COVID-19 肺炎可能带来的教训。

摘要

介绍

SARS-CoV-2感染的主要临床表现是发烧、呼吸困难和间质性肺炎，经常演变为急性呼吸窘迫综合征（ARDS）。

覆盖领域

2019 冠状病毒病 (COVID-19) 的特征与特发性间质性肺病 (ILD) 和与类风湿性关节炎 (RA) 相关的间质性肺病 (ILD) 存在一些共同点，其典型特征是随着时间的推移慢性进展，并可能并发急性加重 (AE)。对常见发病机制（例如 Toll 样受体 4 的参与）的研究可能有助于了解特发性和 RA-ILD 并进行治疗。此外，在特发性 AE 和 RA-ILD 患者中已经显示出在 COVID-19 相关 ARDS 中观察到的过度炎症，主要特征是效应 T 细胞和炎症细胞因子的增加以及凝血级联的激活。在 PubMed、Embase、Scopus 和 Web of Science 中进行了文献检索，并在主要期刊的新冠病毒资源中心进行了手动检索。

专家意见

尽管 COVID-19 肺炎的发病机制尚不确定，但它可能是其他形式的 ILD 和 AE 的可能模型。COVID-19研究的大量数据有助于提出RA-ILD的安全治疗方法、了解普通间质性肺炎的发病机制以及制定新的AE治疗策略。