COVID-19 Disease and Dermatomyositis: A Mini-Review

Abstract

The pandemic of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has caused a large number of deaths, and there is still no effective treatment. COVID-19 can induce a systemic inflammatory response, and its clinical manifestations are diverse. Recently, it has been reported that COVID-19 patients may develop myositis and interstitial pulmonary disease similar to dermatomyositis (DM). This condition is similar to the rapidly progressive interstitial lung disease associated with MDA5⁺ DM that has a poor prognosis and high mortality, and this poses a challenge for an early identification. Suppression of the immune system can protect COVID-19 patients by preventing the production of inflammatory cytokines. This article attempts to explore the possibility of a relationship between COVID-19 and DM in terms of the potential pathogenesis and clinical features and to analyze the therapeutic effect of the immunosuppressive drugs that are commonly used for the treatment of both DM and COVID-19.

Keywords: COVID-19; SARS-CoV-2; dermatomyositis; pathogenesis; treatment.

Figure 1

Common pathogenetic mechanisms between COVID-19 and DM. COVID-19 and DM share three immunogenic linear epitopes with high sequence consistency. SARS-CoV-2 enters human cells through the membranous angiotensin-converting enzyme 2 (ACE2) receptors, triggering an innate and adaptive immune response. This initiates the production of cytokines such as IL-1, IL-6, IL-10 and IFN-γ, which can induce lung and muscle damage. The activation of complement in DM patients results in capillary destruction, which further affects multiple organs, and cytokine storms are associated with the occurrence of certain subtypes of DM.