Editorial
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2021; 9(20): 5352-5357
Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5352
COVID-19: Considerations about immune suppression and biologicals at the time of SARS-CoV-2 pandemic
Giulia Costanzo, William Cordeddu, Luchino Chessa, Stefano Del Giacco, Davide Firinu
Giulia Costanzo, William Cordeddu, Luchino Chessa, Stefano Del Giacco, Davide Firinu, Department of Medical Sciences and Public Health, University of Cagliari, Monserrato 09042, Cagliari, Italy
Author contributions: All the authors contributed equally to this work.
Conflict-of-interest statement: The authors declare that they do not have any conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Davide Firinu, MD, PhD, Assistant Professor, Doctor, Research Fellow, Department of Medical Sciences and Public Health, University of Cagliari, Asse Didattico "E1" Medicina, Cittadella Universitaria, Monserrato 09042, Cagliari, Italy. davide.firinu@unica.it
Received: January 29, 2021
Peer-review started: January 29, 2021
First decision: February 28, 2021
Revised: March 29, 2021
Accepted: May 20, 2021
Article in press: May 20, 2021
Published online: July 16, 2021
Processing time: 158 Days and 21.6 Hours
Abstract

The extent of the profound immunological and nonimmunological responses linked to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is currently being investigated worldwide due to the large burden associated with death due to SARS-CoV-2 and the short-term consequences of coronavirus disease 2019 (COVID-19). It has been hypothesized that patients on immunosuppressive treatments, including biologics, may have an augmented risk of being infected by SARS-CoV-2; however, there are currently no definitive data about biological drugs and COVID-19 in immune-mediated inflammatory diseases. Current epidemiological models developed to understand how long the COVID-19 epidemic may last are not conclusive and range from sustained epidemics to complete elimination. Nevertheless, even in the best-case scenario of apparent elimination, there is concordance about a possible contagion resurgence as late as 2024. Therefore, knowledge of the impact of SARS-CoV-2 on immune-mediated diseases and among patients treated with biologicals, together with the results of novel and promising COVID-19 treatment strategies targeting the virus and the host immune response (or both), will help us to best manage our patients during this pandemic over the next few years.

Keywords: COVID-19; Immune-mediated diseases; Biological drugs; Targeted therapies; Cytokine storm; Immunosuppressive drugs

Core Tip: The severe acute respiratory syndrome coronavirus 2 pandemic has changed health systems worldwide and the current approach to patients affected by chronic diseases such as immune-mediated disorders. To apply personalized medicine, knowledge of the impact of severe acute respiratory syndrome coronavirus 2 during the course of immune-mediated diseases and particularly among patients treated with biologicals, together with the results of novel coronavirus disease 2019 treatment strategies targeting the virus and the host immune response, will help us to best manage our patients during this pandemic.