Sarcoidosis and COVID-19: At the Cross-Road between Immunopathology and Clinical Manifestation
Claudio Tana,
Francesco Cinetto,
Cesare Mantini,
Nicol Bernardinello,
Marco Tana,
Fabrizio Ricci,
Andrea Ticinesi,
Tiziana Meschi,
Riccardo Scarpa,
Francesco Cipollone,
Maria Adele Giamberardino,
Paolo Spagnolo
Affiliations
Claudio Tana
COVID-19 and Geriatrics Clinic, SS. Annunziata Hospital of Chieti, 66100 Chieti, Italy
Francesco Cinetto
Rare Diseases Referral Center, Internal Medicine 1, Ca’ Foncello Hospital-AULSS2 Marca Trevigiana and Department of Medicine-DIMED, University of Padova, 35128 Padova, Italy
Cesare Mantini
Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
Nicol Bernardinello
Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
Marco Tana
COVID-19 and Internal Medicine Unit, SS. Annunziata Hospital of Chieti, 66100 Chieti, Italy
Fabrizio Ricci
Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
Andrea Ticinesi
Internal Medicine Unit, Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria Di Parma, Via Antonio Gramsci 14, 43126 Parma, Italy
Tiziana Meschi
Internal Medicine Unit, Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria Di Parma, Via Antonio Gramsci 14, 43126 Parma, Italy
Riccardo Scarpa
Rare Diseases Referral Center, Internal Medicine 1, Ca’ Foncello Hospital-AULSS2 Marca Trevigiana and Department of Medicine-DIMED, University of Padova, 35128 Padova, Italy
Francesco Cipollone
Medical Clinic, SS. Annunziata Hospital of Chieti, Department of Medicine and Science of Aging, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
Maria Adele Giamberardino
COVID-19 and Geriatrics Clinic, SS. Annunziata Hospital of Chieti, Department of Medicine and Science of Aging and CAST, “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
Paolo Spagnolo
Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
Coronavirus disease 2019 (COVID-19) has been associated with dysregulation of the immune system featuring inappropriate immune responses, exacerbation of inflammatory responses, and multiple organ dysfunction syndrome in patients with severe disease. Sarcoidosis, also known as Besnier–Boeck–Schaumann disease, is an idiopathic granulomatous multisystem disease characterized by dense epithelioid non-necrotizing lesions with varying degrees of lymphocytic inflammation. These two diseases have similar clinical manifestations and may influence each other at multiple levels, eventually affecting their clinical courses and prognosis. Notably, sarcoidosis patients are at high risk of severe COVID-19 pneumonia because of the underlying lung disease and chronic immunosuppressive treatment. In this narrative review, we will discuss interactions between sarcoidosis and COVID-19 in terms of clinical manifestations, treatment, and pathogenesis, including the role of the dysregulated renin–angiotensin system, altered immune responses involving increased cytokine levels and immune system hyperactivation, and cellular death pathways.
