Systemic
lupus erythematosus concurrent with COVID-19: is platelet the right
target?
Jing Wang 1, Lingyan Zhou2 ,
Jing Wang and Lingyan Zhou equally contributed to the work and approved
for final submission.
1 Department of Rheumatology,
The
Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
2 Department of Neurology, The Affiliated Hospital of
Qingdao University, Qingdao, Shandong, China.
Corresponding Author: Lingyan Zhou, E-mail: wjingby2020@163.com
In December 2019, Coronavirus disease 2019
(COVID-19),
caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),
is widely spread and causes a critical threat to clinical burden and
public healthcare. The outbreak of COVID-19 has aroused widespread
concern in the rheumatology
community[1].
Consideration its alarming levels of spread and severity, new biomarkers
are urgently needed to stratify patients’ risk and assess disease
severity. Hematological changes are common in COVID-19 patients, which
include reduced lymphocyte count and platelet count but normal white
blood cell count[2].
Platelet count is a fast, simple, inexpensive and easily available
biomarker. Henry et al indicated that low platelet count is associated
with increased risk of severe disease and mortality in
COVID-19
patients. Platelet count increased the ability to assess COVID-19
patients, and should serve as a practical tool to assess the worsening
illness of COVID-19 patients during
hospitalization[3].
Li et al reported that platelet count was an independent risk factor for
COVID-19 mortality. Baseline platelet levels and dynamic changes were
closely associated with subsequent mortality in COVID-19 patients at
admission. Close monitoring of platelets during hospitalization can help
clinicians develop targeted therapies and provide timely critical care
to patients[4].
Co-occurrence between rheumatic diseases and COVID-19 is a topic worth
considering in clinical rheumatology.
Systemic
lupus erythematosus (SLE) is a common and worldwide
autoimmunity disease, and
thrombocytopenia is a common clinical hematological disorder in SLE. A
longitudinal observational study showed that patients with SLE-related
thrombocytopenia have high disease activity, bad prognosis, and
decreased survival
rate[5]. Dong et al
suggested that an increased risk of mortality and end organ damage in
patients with SLE were related with
thrombocytopenia[6].
Nevertheless, the correlation between thrombocytopenia, COVID-19, and
SLE has not been reported.
When SLE patients are infected with SARS-CoV-2, and accompanied by
thrombocytopenia, is it the cause of SLE or SARS-CoV-2 infection, will
SARS-CoV-2 increase the disease activity and severity of SLE patients?
How to continue to manage SLE in the context of the COVID-19 pandemic?
How rheumatologists use their own basic knowledge and rich clinical
experience to judge and choose drugs to achieve the best therapeutic
effect?
Platelet is an important biomarker and should be monitored when
co-occurrence between SLE and COVID-19. The mechanism of
thrombocytopenia in the development of COVID-19 and SLE is still unclear
and needs to be clarified by further clinical and basic research.
Conflicts of InterestThe authors declare that they have no conflicts of interest.