key: cord-0869802-xe8fn3vr
authors: Güder, Semih; Güder, Hüsna
title: The course of COVID‐19 infection and prolonged sneezing and nasal congestion in a patient using ixekizumab
date: 2021-02-23
journal: Dermatol Ther
DOI: 10.1111/dth.14894
sha: 47d1d9d90c723d925935aeda3da06673c8695d7e
doc_id: 869802
cord_uid: xe8fn3vr

nan

Favipiravir treatment was completed and stopped on the fifth day.

At the end of the first week, the dyspnea was completely recovered, and the fever did not occur after discharge. After a week, symptoms of sneezing and nasal congestion started. Two SARS-CoV-2 nasopharyngeal swab samples repeated 30 days after the initial diagnosis yielded negative results. One ixekizumab dose was skipped, and the treatment continued 1 month later. The patient had not new psoriatic lesions, and joint complaints during and after the COVID 19 infection. The psoriasis area severity index (PASI) value of the patient, which was 11.8 when she started the ixekizumab treatment, was measured as 1.2 in the sixth week of the treatment. The PASI value did not change during and after the COVID-19 infection.

Interleukin-17 (IL-17) was considered to promote viral persistence by inhibiting the apoptosis of virus-infected cells and to cause Th17-related cytokine storm syndrome. 1 In a recent study of the Italian psoriasis-biologics-COVID working group, the researchers thought that biological therapies could reduce the cytokine storm which may lead to multiorgan failure, ARDS, and death. 2 Therefore, inhibition of IL-17 may have contributed to the mild course of the disease in the present case.

Although the assumption that IL-17 causes asthma pathology is not clear, it was revealed that IL-17A contributed to airway hyperresponsiveness in mouse models, and increased levels of airway IL-17A were observed in humans with severe asthma. 3 The patient developed sneezing and nasal congestion symptoms in the second week after the last administration of ixekizumab. This may be due to the re-increase of IL17A levels in the respiratory tract mucosa which causes airway sensitivity.

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