Demographics, clinical characteristics at admission, laboratory features, treatment and outcomes of four patients with BD and COVID-19
| Patient 1 | Patient 2 | Patient 3 | Patient 4 | |
| Demographic and BD status | ||||
| Age (years) | 40 | 51 | 37 | 47 |
| Gender | Female | Female | Female | Female |
| Comorbidities | None | Breast cancer | None | None |
| BD manifestations | ||||
| Oral aphthosis | Yes | Yes | Yes | Yes |
| Genital aphthosis | Yes | Yes | Yes | Yes |
| Ocular lesions | Yes | No | Yes | No |
| Vascular manifestations | Yes | No | No | No |
| Neurological manifestations | No | No | Yes | No |
| IMT before admission | PDN 5 mg/day | COL 1 mg/day | PDN 7.5 mg/day | Pentoxifiline 400 mg/day |
| MTX 20 mg/week | AZA 100 mg/day | |||
| COL 0.5 mg/day | ||||
| Duration of symptoms (days) | 6 | 4 | 2 | 7 |
| Clinical manifestations (at admission) | ||||
| Temperature | Fever (39°C) | Fever (38.5°C) | Fever (38.5°C) | Fever (38.5°C) |
| Symptoms | Cough, malaise, diarrhoea, headache | Cough, malaise, sore throat, headache | cough | Cough, malaise, sore throat, anosmia, ageusia, headache |
| Thrombosis | No | No | No | No |
| O2 saturation (in ambient air) | SpO2 95% | SpO2 95% | SpO2 96% | ND |
| Chest X-ray findings | Left basal ground-glass opacity | Normal | Normal | Normal |
| Laboratory results* | ||||
| White blood cell count (×10⁶/L) | 10 000 | 2340 | 6250 | ND |
| Lymphocyte (×10⁶/L) | 3200 | 870 | 1380 | ND |
| Platelets (×10⁶/L) | 685 000 | 158 000 | 331 000 | ND |
| LDH (U/L) | 207 | 168 | 155 | ND |
| C reactive protein (mg/dL) | 2.7 | 0.4 | 0.91 | ND |
| Ferritin (ng/mL) | 295 | 152 | 130 | ND |
| D-dimer (ng/mL) | 357 | 400 | 800 | ND |
| Procalcitonin (ng/mL) | 0.05 | <0.03 | ND | ND |
| Treatments | ||||
| IMT during admission | MTX stopped | COL stopped | PDN, AZA, COL | None |
| Lopinavir/ritonavir | Yes | Yes | Yes | No |
| Hydroxychloroquine | Yes | Yes | Yes | No |
| Azithromycin | Yes | Yes | Yes | No |
| Corticosteroids | Same dose | No | Same dose | No |
| Tocilizumab | No | No | No | No |
| LMWH | No | No | No | No |
| Others | Ceftriaxone | No | Ceftriaxone | No |
| Outcomes | ||||
| Admitted to an intensive care unit | No | No | No | No |
| Invasive or non-invasive mechanical ventilation | No | No | No | No |
| Length of hospital stay (days) | 8 | 6 | 6 | No hospital admission |
| Length of home hospitalisation (days)† | 18 | – | 8 | 15 |
| Outcomes | Cured | Cured | Cured | Cured |
| Comments | No BD flare during or after COVID-19 infection | BD flare during COVID-19 infection (oral aphthosis and erythema nodosum) COL reinitiated at 6 days | No BD flare during or after COVID-19 infection | BD flare 15 days after COVID-19 infection (oral and genital aphthosis) |
| MTX reinitiated at 3 weeks | COL initiated at 15 days | |||
Lopinavir-boosted ritonavir was given as 400 mg of ritonavir boosted with 100 mg of lopinavir twice a day for 14 days; azithromycin was given as 500 mg once a day, with a loading dose on the first day, and then 250 mg once a day for 4 days; hydroxychloroquine was given as 400 mg twice a day with a loading dose on the first day and then 200 mg twice a day for 4 days.
*Worst laboratory result.
†Discharged with a supervised home-care programme.
AZA, azathioprine; BD, Behçet’s disease; COL, colchicine; IMT, immunomodulatory treatment; LDH, lactate dehydrogenase; LMWH, low-molecular-weight heparin; MTX, methotrexate; ND, not done; PDN, prednisone.