Prolonged presence of SARS-CoV-2 in a COVID-19 case with rheumatoid arthritis taking iguratimod treated with ciclesonide

Hiroaki Baba; Hajime Kanamori; Kengo Oshima; Issei Seike; Ikumi Niitsuma-Sugaya; Kentaro Takei; Yukio Sato; Koichi Tokuda; Tetsuji Aoyagi

doi:10.1016/j.jiac.2020.06.022

Prolonged presence of SARS-CoV-2 in a COVID-19 case with rheumatoid arthritis taking iguratimod treated with ciclesonide

J Infect Chemother. 2020 Oct;26(10):1100-1103. doi: 10.1016/j.jiac.2020.06.022. Epub 2020 Jul 1.

Authors

Hiroaki Baba¹, Hajime Kanamori², Kengo Oshima³, Issei Seike⁴, Ikumi Niitsuma-Sugaya⁴, Kentaro Takei⁴, Yukio Sato⁵, Koichi Tokuda², Tetsuji Aoyagi³

Affiliations

¹ Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan; Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. Electronic address: [email protected].
² Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan; Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan; Division of Infection Control, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
³ Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan; Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
⁴ Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
⁵ Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan; Sendai Medical Imaging Clinic, 2-1-25 Itsutsubashi, Aoba-ku, Sendai, Miyagi, 980-0022, Japan.

Abstract

We report a coronavirus disease 2019 (COVID-19) case with rheumatoid arthritis taking iguratimod. The patient who continued iguratimod therapy without dose reduction was treated with ciclesonide had an uneventful clinical course, but prolonged detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was observed after resolution of symptoms. The effects of disease-modifying antirheumatic drugs (DMARDs) and ciclesonide on clinical course and viral shedding remain unknown and warrant further investigation.

Keywords: Ciclesonide; Coronavirus disease 2019; Iguratimod; Viral shedding.

Publication types

Case Reports

MeSH terms

Adult
Antirheumatic Agents / therapeutic use
Arthritis, Rheumatoid / complications
Arthritis, Rheumatoid / drug therapy*
Betacoronavirus*
COVID-19
Chromones / therapeutic use*
Coronavirus Infections / complications*
Coronavirus Infections / diagnosis
Female
Humans
Pandemics
Pneumonia, Viral / complications*
Pneumonia, Viral / diagnosis
Pregnenediones / therapeutic use*
RNA, Viral
Real-Time Polymerase Chain Reaction
SARS-CoV-2
Sulfonamides / therapeutic use*
Thorax / diagnostic imaging
Virus Shedding

Substances

Antirheumatic Agents
Chromones
Pregnenediones
RNA, Viral
Sulfonamides
iguratimod
ciclesonide