COVID-19 Associated Vasculitis Confirmed by the Tissues RT-PCR: A Case Series Report
Konstantin E. Belozerov,
Ilia S. Avrusin,
Lyubov I. Andaryanova,
Anna M. Guseva,
Zaira S. Shogenova,
Irina N. Belanovich,
Anna V. Lobacheva,
Tatiana L. Kornishina,
Eugenia A. Isupova,
Vera V. Masalova,
Olga V. Kalashnikova,
Andrey V. Nokhrin,
Tatyana F. Panova,
Yulia P. Dutova,
Svetlana L. Myshkovskaya,
Kirill Y. Kostyunin,
Andrey B. Komissarov,
Vyacheslav G. Chasnyk,
Liudmila V. Bregel,
Mikhail M. Kostik
Affiliations
Konstantin E. Belozerov
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Ilia S. Avrusin
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Lyubov I. Andaryanova
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Anna M. Guseva
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Zaira S. Shogenova
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Irina N. Belanovich
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Anna V. Lobacheva
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Tatiana L. Kornishina
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Eugenia A. Isupova
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Vera V. Masalova
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Olga V. Kalashnikova
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Andrey V. Nokhrin
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Tatyana F. Panova
Pediatric Department, Leningrad Regional Children’s Clinical Hospital, 195009 Saint Petersburg, Russia
Yulia P. Dutova
Pediatric Department, Leningrad Regional Children’s Clinical Hospital, 195009 Saint Petersburg, Russia
Svetlana L. Myshkovskaya
Pediatric Department, Leningrad Regional Children’s Clinical Hospital, 195009 Saint Petersburg, Russia
Kirill Y. Kostyunin
Pathology Department, Irkutsk State Medical University, 664003 Irkutsk, Russia
Andrey B. Komissarov
Laboratory of Molecular Virology, Smorodintsev Research Institute of Influenza, 197376 Saint Petersburg, Russia
Vyacheslav G. Chasnyk
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Liudmila V. Bregel
Department of Pediatrics, Irkutsk State Medical Academy of Postgraduate Education, Branch of Russian Medical Academy of Continuous Professional Education, 664049 Irkutsk, Russia
Mikhail M. Kostik
Hospital Pediatry, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia
Background: Several cases of skin and central nervous system vasculopathy associated with COVID-19 in children have been published, but the information is rather limited. Our study aimed to describe these cases of vasculitis associated with COVID-19 in children. Methods: In the retrospective-prospective case series study we included information regarding four children with COVID-19-associated vasculitis. In every case, we had a morphological description and the etiology was confirmed via real-time polymerase chain reaction during a tissue biopsy. Results: The most involved systems were skin (4/4), respiratory (3/4), cardiovascular (2/4), nervous (1/4), eye (1/4), kidney (1/4), and inner year (1/4). All patients had increased inflammatory markers and thrombotic parameters (D-dimer). No patient met the criteria for multisystem inflammatory syndrome in children. Two patients met polyarteritis nodosa criteria, one met Henoch–Schonlein purpura criteria, and one met unclassified vasculitis criteria. All patients were treated with systemic glucocorticosteroids (two-pulse therapy). Non-biologic DMARDs were prescribed in all cases; 1/4 patients (25%) was treated with intravenous immunoglobuline, and 3/4 (75%) were treated with biologics (etanercept, tocilizumab, and adalimumab). Conclusions: Vasculitis associated with COVID-19 could be a life-threatening condition; SARS-CoV-2 might be a new trigger or etiological agent for vasculitis and other immune-mediated diseases. Further research and collection of similar cases are required.
