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Correspondence
Challenge of diagnosing ANCA-associated vasculitis during COVID-19 pandemic: a missed ‘window of opportunity’
  1. Alessandro Giollo1,
  2. Riccardo Bixio1,
  3. Davide Gatti1,
  4. Ombretta Viapiana1,
  5. Luca Idolazzi1,
  6. Christian Dejaco2,3,
  7. Maurizio Rossini1
  1. 1Department of Medicine, Rheumatology Unit, Universita degli Studi di Verona, Verona, Italy
  2. 2Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria
  3. 3Department of Rheumatology, Hospital of Brunico (SABES-ASDAA), Brunico, Italy
  1. Correspondence to Dr Alessandro Giollo, Department of Medicine, Rheumatology Unit, Universita degli Studi di Verona, Verona 37129, Italy; alessandrogiollo{at}gmail.com

http://dx.doi.org/10.1136/annrheumdis-2020-218830

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    There is concern around coronavirus disease 2019 (COVID-19) and rheumatic diseases. Systemic vasculitis was the fourth most common rheumatic disease among patients hospitalised for COVID-19.1 However, the diagnosis of anti-neutrophil cytoplasm antibodies (ANCA)-associated vasculitis (AAV) can be challenging during COVID-19 pandemic for several reasons: first, clinical presentation of patients with AAV partially overlaps with COVID-19; second, patients with initial symptoms of AAV may be concerned to seek medical help in order not to get into close contact with other patients; and third, diagnosis may be delayed because non-urgent tests and visits might have been postponed due to COVID-19 related closure of services. Herein, we report the poor and irreversible clinical outcomes of diagnostic delay of AAV during the COVID-19 pandemic.

    We recently encountered a cluster of nine life-threatening presentations of new-onset or relapsing AAV admitted to a Verona hospital, all negative for SARS-CoV-2 by nasopharyngeal swab or bronchoalveolar fluid aspiration. We compared clinical characteristics of this group presenting in the time frame of 6 weeks during the second trimester of 2020 …

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    Footnotes

    • Contributors AG: provided the conception of the study, literature search and interpretation of data, drafting the article and revised it critically for important intellectual content. RB: provided data search, interpretation of data, drafting the article and revised it critically for important intellectual content. All authors: revised the article critically for important intellectual content and gave final approval of the version to be submitted.

    • 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.

    • Patient consent for publication Not required.

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