Moderator of 2 Sessions
Presenter of 3 Presentations
O008 - COVID-19 AND THE HYPERFERRITINEMIC SYNDROMES (ID 706)
Abstract
Background and Aims
Background: The hyperferritinemic syndromes include macrophage activation syndrome, adult onset Still's disease, catastrophic antiphospholipid syndrome, and septic shock. The syndrome is characterized by life threatening disease due to the development of a cytokine storm, multi-organ damage, elevated ferritin levels, and the response to similar therapies. Aims: Proof of concept for severe COVID-19 as a hyperferritinemic syndrome.
Methods
Methods: We reviewed the literature on elevated levels of ferritin in sever COVID-19.
Results
Results: In the third phase of SARS-COV2 disease, the hyper-inflammatory phase, elevated ferritin levels and the development of a cytokine storm are present. A new entity, multisystem inflammatory syndrome (MIS), described predominantly in pediatric patients, mimics MAS, yet develops without a previous symptomatic disease. In these patients, hyperferritinemia is prominent. Elevated ferritin levels in COVID-19 intensive care unit patients predicts mortality. Ferritin levels in non-survivors are much higher than those who survive. Consecutive measurements of a rising ferritin level may predict the need for assisted ventilation. Treatments such as corticosteroids, biologics, and IVIG may also be beneficial for COVID-19 as they are for the other hyperferritinemic syndromes.
Conclusions
Conclusion: Severe COVID-19 may be recognized as one of the hyperferritinemic syndromes.
O058 - SLE AND INFECTIONS- AN UPDATE (ID 769)
Abstract
Background and Aims
Lupus patients are more prone to infections than the normal population and may be due to the dysfunction of their immune system. Infections may occur early in the diagnosis of SLE and/or peak after 5 years of disease. In addition, lupus patients will be more prone to severe infections if they are treated with very potent immunosuppressive drugs. Infections may be a trigger to the development or exacerbation of lupus
Methods
. Infections can mimic a flare of lupus, where the appropriate diagnosis and therapy can prevent morbidity and mortality. In addition, SLE and infections may be concurrent in 41% of cases. In these patients, an elevated CRP will indicate infection. Hospitalized lupus patients are more prone to develop infections that are hospital acquired, activation of latent pathogens, or opportunistic pathogens.
Results
Over the past four decades, infection rates have not declined and remain a major cause of death in SLE patients. In the past decade, hospital and ICU admissions are for sepsis more than pneumonia as in the past. There is no decline in the mortality rates due to infections.
Conclusions
There has been a significant improvement in the diagnosis of infections and a major increase of available antibiotics. However, one of the major causes of death remains severe infections in lupus patients. This finding indicates that possibly different unknown mechanisms do not participate in the fight against infections in this prototopic autoimmune disease.
O088 - IVIG THERAPY- AN UPDATE AND FOCUS ON COVID-19 (ID 707)
Abstract
Background and Aims
For a variety of autoimmune diseases, IVIG is an add-on off-label therapy that is beneficial, safe, and may be utilized for long-term therapy.
Methods
IVIG is recommended for patients with concomitant flare and infection. IVIG is beneficial for ICU patients with sepsis or autoimmune disease.
Results
IVIG has many forms (IVIG, sIVIG, scIVIG). sIVIG and scIVIG may be beneficial for COVID-19 infection.
Conclusions
Here, we present an update on IVIG therapy, with the focus on therapy for COVID-19.