key: cord-0918660-c2p97cd0
authors: Yu. Olisova, O.; Anpilogova, E. M.; Svistunova, D.A.
title: Apremilast as a potential treatment option for COVID‐19: no symptoms of infection in a psoriatic patient
date: 2020-05-24
journal: Dermatol Ther
DOI: 10.1111/dth.13668
sha: 8fe73aba2f4bc4669989b4bc8d466f6240e398ad
doc_id: 918660
cord_uid: c2p97cd0

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The authors have no conflict of interest to declare Funding sources: The article has no funding source Disclosure statements: Dr. Olisova has nothing to disclose. Dr. Anpilogova has nothing to disclose. Dr. Svistunova has nothing to disclose. infection. He was a high-risk patient with the possibility of a very bad prognosis because of obesity along with recent chemotherapy for a persisting brain tumour. However, the COVID-19 was This article is protected by copyright. All rights reserved.

clinically cured within a week of admission to an intensive care unit without stopping the apremilast therapy. 8 The authors concluded that the safety of apremilast in COVID-19 was confirmed, without interfering with the infection. However, no information is available about how long he had been using apremilast when he was infected with COVID-19.

We would like to report a case of a 61-year old male suffering from moderate psoriasis for almost 15 years. Since September 2019 he has been treated with apremilast in a recommended dosing regimen (30 mg orally twice a day), which has led to complete remission. He was previously treated by PUVA phototherapy and conventional systemic treatment including methotrexate. In mid-April his wife and children, who live all together with the patient, were diagnosed as being SARS-CoV-2 positive and developed symptoms of infection including severe cough with fever (38.5-39.1°C), bilateral interstitial pneumonia, myalgia, anosmia and fatigue. Despite the prolonged close contact with his family members during self-isolation, with all the inherent risks of contracting the disease, and the added vulnerability due to age, the patient had no symptoms of infection. However, due to the contact with COVID-19 positive subjects the patient was quarantined for 14 days and tested for coronavirus using nasopharyngeal swab, which was positive. CT findings revealed no pulmonary changes.

Such an infection route may be regarded as a result of taking apremilast for 8 months by the time of contact with COVID-19, and we suppose that the drug has already been accumulated in the body, resulting in its defence against COVID-19. This is due to its mechanism of action, which has the following sequence: phosphodiesterase inhibition, increase in intracellular cAMP levels and a decreased expression of tumor necrosis factor (TNF)-α, which is reported to be markedly increased during COVID-19. 9 COVID-19 pandemic has spread all around the world with, to date, 4,586,915 confirmed cases and 309,184 deaths. 10 However, currently no specific treatments exist. We suggest that ongoing treatment with PDE-4 inhibitor apremilast might play a protective role against the evolution of the infection. Nevertheless, further investigations are needed to confirm our hypothesis.

The patients in this manuscript have given written informed consent to the publication of their case details.

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