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Correspondence
Correspondence on ‘Glucocorticoid-induced relapse of COVID-19 in a patient with sarcoidosis’
  1. Florence Jeny1,
  2. Raphael Lhote2,
  3. Gwenael Lorillon3,
  4. Nicolas Belhomme4,
  5. Grégory Pugnet5,6,
  6. Raphaël Borie7,
  7. Aurélien Justet8,
  8. Stephane Jouneau9,
  9. Nathalie Freymond10,
  10. Arsène Mekinian11,
  11. Robin Dhote12,
  12. Yacine Tandjaoui-Lambiotte13,
  13. Nathalie Saindenberg14,
  14. Pierre Gazengel15,
  15. Baptiste Hervier16,
  16. Julien Haroche2,
  17. Alexis Mathian2,
  18. Miguel Hié2,
  19. Thibaud Chazal2,
  20. Dov Taieb2,
  21. Yurdagul Uzunhan1,
  22. Jérôme Le Pavec15,
  23. Isabella Annesi-Maesano17,
  24. Emmanuel Bergot18,
  25. Abdellatif Tazi3,
  26. Zahir Amoura2,
  27. Dominique Valeyre1,
  28. Hilario Nunes1,
  29. Fleur Cohen-Aubart2
  1. 1 Service de Pneumologie, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Bobigny, France
  2. 2 Sorbonne Université, Service de Médecine Interne 2, maladies auto-immunes et systémiques, Assitance Publique Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Paris, France
  3. 3 Service de Pneurmologie, Assistance Publique Hôpitaux de Paris, Hopital Saint-Louis, Paris, France
  4. 4 Département de Médecine Interne et Immunologie Clinique, CHU Rennes, Rennes, France
  5. 5 UMR1027, Service de Médecine Interne, INSERM et CHU de Toulouse, Toulouse, France
  6. 6 Service de Médecine Interne, CHU Toulouse, Toulouse, France
  7. 7 Service de Pneumologie, Assistance Publique Hôpitaux de Paris, Hôpital Bichat, Paris, France
  8. 8 Service de Pneumologie, CHU Caen, Caen, Basse-Normandie, France
  9. 9 Service de pneumologie, CHU de Rennes, Rennes, France
  10. 10 Service de Pneumologie, Centre hospitalier Lyon Sud, Lyon, France
  11. 11 Service de Médecine Interne, DHUi2B, Assistance Publique Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
  12. 12 Service de Médecine Interne, Assitance Publique Hôpitaux de Paris, Hôpital Avicenne, Bobigny, France
  13. 13 Service de Réanimation Médico-Chirurgicale, Hôpital Avicennes, AP-HP, HUPSSD, Bobigny, France
  14. 14 Service de Rhumatologie, Hôpital Avicenne, Bobigny, France
  15. 15 Service de Pneumologie, Centre chirurgical Marie Lannelongue, Le Plessis Robinson, France
  16. 16 Service de Médecine Interne, Assitance Publique Hôpitaux de Paris, Hôpital Saint Louis, Paris, France
  17. 17 Equipe EPAR, INSERM UMRS 1136, Paris, France
  18. 18 Service de Rhumatologie, CHU de Caen, Caen, France
  1. Correspondence to Dr Fleur Cohen-Aubart, Internal Medicine Department, APHP, Paris, Île-de-France, France; fleur.cohen{at}psl.aphp.fr

https://doi.org/10.1136/annrheumdis-2020-218957

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    Patients with interstitial lung disease have been considered at high risk of complications of COVID-19 because of their underlying lung disease and use of immunosuppressive agents.1 However, data on COVID-19 in patients with sarcoidosis are scarce.2–4 Several reasons for an increased risk of severe forms of COVID-19 among sarcoidosis patients have been hypothesised: the involvement of the lung in almost 90% of patients with COVID-19, some of whom have reduced pulmonary function and comorbidities such as diabetes or hypertension, which are largely associated with the use of glucocorticosteroids for treating sarcoidosis; and the use of immunosuppressive agents in a subset of these patients.5 Recently, Gyorfi et al 6 described the case of a patient with sarcoidosis who experienced a symptomatic SARS-CoV-2 infection with spontaneous clinical improvement, and a virological relapse after steroids treatment. This case illustrated the fact that immunosuppression with glucocorticoids may induce relapse of COVID-19 in patients with sarcoidosis. However, we lack data on the outcomes of patients with sarcoidosis affected by COVID-19. We retrospectively collected data for all patients with sarcoidosis and SARS-CoV-2 infection seen among 15 French centres between 1 March and 20 May 2020. The inclusion criteria were a sarcoidosis diagnosis based on the American Thoracic Society/European Respiratory Society/World Association for Sarcoidosis and other granulomatous …

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    Footnotes

    • FJ and RL are joint first authors.

    • HN and FC-A are joint senior authors.

    • FJ and RL contributed equally.

    • HN and FC-A contributed equally.

    • Contributors FC-A, DV and HN designed the study. All authors collected the data. RL, IA-M and FC-A conducted the statistical analysis. FJ, RL, GP, GL, DV, HN and FC-A analyzed and interpreted the data. FJ, RL and FC-A wrote the manuscript. All authors critically reviewed and approved the final version of the manuscript. FJ, RL and FC-A took full responsibility for the integrity of the work. FC-A and HN contributed equally to this work and are co-last authors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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