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The systemic sclerosis patient in the COVID-19 era: the challenging crossroad between immunosuppression, differential diagnosis and long-term psychological distress.

新型冠状病毒肺炎时代的系统性硬化症患者: 免疫抑制、鉴别诊断疾病和长期心理困扰之间的挑战性十字路口。

  • 影响因子:2.26
  • DOI:10.1007/s10067-020-05193-2
  • 作者列表:"Orlandi M","Lepri G","Bruni C","Wang Y","Bartoloni A","Zammarchi L","Cometi L","Guiducci S","Matucci-Cerinic M","Bellando-Randone S
  • 发表时间:2020-07-01
Abstract

:COVID-19 is a world health emergency which may inevitably affect the management of a complex autoimmune disease such as systemic sclerosis (SSc). Several SSc patients are frail and, in this pandemic, need a careful protection. The COVID-19 infection might complicate the clinical scenario of interstitial lung disease (ILD) in SSc because it determines a severe pneumonia characterized by radiological features similar to SSc-ILD. The striking CT similarities between the 2 diseases make it difficult to distinguish a worsening of SSc-ILD from COVID-19-ILD superinfection. Moreover, other aspects, like isolation during lock down, may cause a significant psychological stress which will pile up on the already difficult contact with the patients for a routine check-up. Moreover, the drug shortage is a real problem in these times. For these reasons, the rheumatologist in daily clinical practice should carefully differentiate the possible COVID-19 infection in order to optimize the patient management. Therefore, the challenge in everyday life will be to achieve in due time the differential diagnosis as well as the long-term psychological impact.Key Points• SSc patients should be encouraged to continue their chronic therapy; in case of immunosuppressive therapy it must be discontinued for safety in case of COVID-19 infection.• Psychological support must be guaranteed to every SSc patients.• COVID-19 pneuminia is hard to distinguish from an interstitial lung disease due to SSc lung involvment.• Data sharing is fundamental for an optimal managment of SSc patients during COVID-19 pandemia.

摘要

: 新型冠状病毒肺炎是世界卫生紧急事件,可能不可避免地影响复杂自身免疫性疾病,如系统性硬化症 (SSc) 的管理。一些SSc患者身体虚弱,在这种大流行中,需要小心保护。新型冠状病毒肺炎感染可能使SSc间质性肺疾病 (ILD) 的临床情况复杂化,因为它决定了具有类似于SSc-ILD的放射学特征的重症肺炎。引人注目的CT相似性 2 疾病使得很难区分恶化SSc-ILD从COVID-19-ILD二重感染.此外,其他方面,如锁定期间的隔离,可能会导致明显的心理压力,这将堆积在已经难以与患者进行常规检查的接触上。此外,在这些时代,药物短缺是一个真正的问题。由于这些原因,日常临床实践中的风湿病专家应该仔细区分可能的新型冠状病毒肺炎感染,以优化患者管理。因此,面临的挑战在日常生活中,将是实现适时鉴别诊断疾病以及长期的心理影响.要点 • SSc患者应鼓励继续进行长期治疗;在免疫抑制治疗的情况下,为了安全起见,必须停止新型冠状病毒肺炎感染。• 心理支持必须保证每一个SSc患者。• 新型冠状病毒肺炎pneuminia很难与SSc肺受累所致的间质性肺病区分开来。• 数据共享是SSc患者在新型冠状病毒肺炎菌血症期间最佳管理的基础。

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影响因子:4.36
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翻译标题与摘要 下载文献
影响因子:2.48
发表时间:2020-04-01
来源期刊:Infection
DOI:10.1007/s15010-020-01401-y
作者列表:["Cheng ZJ","Shan J"]

METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.

呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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