key: cord-0704043-kx2vwdo2
authors: Förster-Ruhrmann, Ulrike; Szczepek, Agnieszka J.; Claus Bachert, habil; Heidi Olze, habil
title: COVID-19 infection in a patient with severe chronic rhinosinusitis with nasal polyps during therapy with dupilumab
date: 2020-05-15
journal: J Allergy Clin Immunol
DOI: 10.1016/j.jaci.2020.05.005
sha: 764682890e624aa802b40781413d7a61b920c5e1
doc_id: 704043
cord_uid: kx2vwdo2

A patient with severe CRSwNP, asthma, and NSAIDS received dupilumab treatment. Three weeks after therapy onset, the patient was diagnosed with Covid-19, had a mild course of the disease, and fully recovered from the infection.

Capsule Summary: 31 A patient with severe CRSwNP, asthma, and NSAIDS received dupilumab treatment. Three 32 weeks after therapy onset, the patient was diagnosed with Covid-19, had a mild course of 33 the disease, and fully recovered from the infection. 34 To the Editor: 36 37 Monoclonal antibodies ( biologics ) such as dupilumab , a fully human monoclonal antibody 38 blocking interleukin-4 and interleukin-13 signaling, started recently to be successfully used 39 also for the treatment of severe forms of chronic rhinosinusitis with nasal polyps (1). 40 Currently, no data is available on whether the therapy with dupilumab influences the risk of 41 infection with the coronavirus (SARS-CoV-2) or if it modulates the course of disease. 43 Here, we report a case of a 53-years-old female patient (BMI 23.5) treated with dupilumab 44 for uncontrolled severe CRSwNP, who developed a COVID-19 infection. Twenty years ago, 45 the patient consulted her physician because of rhinitis, which was consecutively diagnosed 46 as CRSwNP. At that time, she also developed asthma, and in 2005, reported respiratory 47 symptoms following intake of two different NSAIDs. No further diagnostic tests were 48 performed. Despite the administration of oral prednisolone three times a year, the 49 regrowing nasal polyps had to be surgically removed in 2012, 2016, and 2019. She was 50 receiving prednisolone due to recurrent documented nasal polyps extending beyond the 51 middle nasal passage on both sides (Davos Score 4 NP, a sum of both sides). The last course 52 of prednisolone was administered in January 2020. In February 2020, the patient was 53 admitted to our outpatient department for possible alternative treatment and was offered 54 therapy with dupilumab for uncontrolled CRSwNP. Also, she was administered mometasone 55 furoate 400 µg/ day; fluticasone/salmeterol 250/ 50 µg 2-0-2; and salbutamol when needed. 56 The following set of clinical tests used in our clinic as a standard to characterize the patients 57 with CRSwNP was applied: 58 • Rhinological parameters: Nasal endoscopy Davos-score score 1: NP in middle meatus 59 only; score 2: NP beyond middle meatus; score 3: NP not blocking the nose 60 completely; score 4: NP completely obstructing the nose; a sum of both nasal sides. 61 • Pulmonary parameters: the asthma control test (ACT)-score with ACT-score ≥ 20 as 62 controlled asthma; ACT-score < 20 as uncontrolled asthma (2) At presentation, the pulmonary parameters of the patient were FEV1/ FVC ratio 62%; FEV1 70 57%; Asthma Control Test (ACT) score 16 (see Table 1 ). Dupilumab (300mg) was 

Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020. E2. Neurology BoDotSSo. Covid-19: Recommendations of the Spanish Society of Neurology (SEN) in relation to the loss of smell as a possible early symptom of CoVID-19 infection2020

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