TY - JOUR
T1 - Challenges in the management of patients with systemic light chain (AL) amyloidosis during the COVID-19 pandemic
AU - Kastritis, Efstathios
AU - Wechalekar, Ashutosh
AU - Schönland, Stefan
AU - Sanchorawala, Vaishali
AU - Merlini, Giampaolo
AU - Palladini, Giovanni
AU - Minnema, Monique
AU - Roussel, Murielle
AU - Jaccard, Arnaud
AU - Hegenbart, Ute
AU - Kumar, Shaji
AU - Cibeira, Maria T.
AU - Blade, Joan
AU - Dimopoulos, Meletios A.
PY - 2020
Y1 - 2020
N2 - The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated coronavirus disease 2019 (COVID-19) is primarily manifested as a respiratory tract infection, but may affect and cause complications in multiple organ systems (cardiovascular, gastrointestinal, kidneys, haematopoietic and immune systems), while no proven specific therapy exists. The challenges associated with COVID-19 are even greater for patients with light chain (AL) amyloidosis, a rare multisystemic disease affecting the heart, kidneys, liver, gastrointestinal and nervous system. Patients with AL amyloidosis may need to receive chemotherapy, which probably increases infection risk. Management of COVID-19 may be particularly challenging in patients with AL amyloidosis, who often present with cardiac dysfunction, nephrotic syndrome, neuropathy, low blood pressure and gastrointestinal symptoms. In addition, patients with AL amyloidosis may be more susceptible to toxicities of drugs used to manage COVID-19. Access to health care may be difficult or limited, diagnosis of AL amyloidosis may be delayed with detrimental consequences and treatment administration may need modification. Both patients and treating physicians need to adapt in a new reality.
AB - The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated coronavirus disease 2019 (COVID-19) is primarily manifested as a respiratory tract infection, but may affect and cause complications in multiple organ systems (cardiovascular, gastrointestinal, kidneys, haematopoietic and immune systems), while no proven specific therapy exists. The challenges associated with COVID-19 are even greater for patients with light chain (AL) amyloidosis, a rare multisystemic disease affecting the heart, kidneys, liver, gastrointestinal and nervous system. Patients with AL amyloidosis may need to receive chemotherapy, which probably increases infection risk. Management of COVID-19 may be particularly challenging in patients with AL amyloidosis, who often present with cardiac dysfunction, nephrotic syndrome, neuropathy, low blood pressure and gastrointestinal symptoms. In addition, patients with AL amyloidosis may be more susceptible to toxicities of drugs used to manage COVID-19. Access to health care may be difficult or limited, diagnosis of AL amyloidosis may be delayed with detrimental consequences and treatment administration may need modification. Both patients and treating physicians need to adapt in a new reality.
KW - amyloidosis
KW - COVID-19
KW - hydroxychloroquine
KW - remdesivir
KW - tocilizumab
UR - http://www.scopus.com/inward/record.url?scp=85087438151&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85087438151&partnerID=8YFLogxK
U2 - 10.1111/bjh.16898
DO - 10.1111/bjh.16898
M3 - Article
C2 - 32480420
AN - SCOPUS:85087438151
JO - British Journal of Haematology
JF - British Journal of Haematology
SN - 0007-1048
ER -