Case Report
Volume 12 Issue 7 - 2021
Severe Covid-19 is a Risk Factor for Gout Even in Hypouricaemic ICU Patients. Sign of Arousal of NLPR3 Activation?
Tim L Th A Jansen1*, Ioana Hotea1,2 and Jos LML le Noble3,4
1Department of Rheumatology, VieCuri Medical Centre, Venlo, Venlo, The Netherlands
2Department of Rheumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
3Department of Intensive Care, BX VieCuri Medical Centre, Venlo, Venlo, The Netherlands
4Departments of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre, AZ Maastricht, The Netherlands
*Corresponding Author: Tim L Th A Jansen, Department of Rheumatology, VieCuri Medical Centre, Venlo, Venlo, The Netherlands.
Received: May 14, 2021; Published: June 08, 2021




Abstract

Severe Acute Respiratory Syndrome Corona Virus type 2 (SARS-CoV2) causes a mild to a fulminant respiratory viral infection by entering via ACE2 receptors. In some cases, the host response is upregulated to a fulminant cytokine storm or better cytokine release syndrome (CRS). In early infections with a mild course, it has been shown that increased levels of interleukin 1 beta, interleukin 1 Receptor Antagonist, interleukin 6, tumor necrosis factor alpha, interleukin 10 and soluble urokinase plasminogen activator receptor are in circulation with an increased expression of NOD-Like Receptor Pyrin domain 3 (NLRP3) [1]. Some studies indeed have shown a prompt clinical improvement with IL1 blockade [2-5]. At Intensive Care Units these SARS-CoV2-induced cases are often seen with an acute respiratory distress syndrome (ARDS) being the predominant and primary cause of death among SARS-CoV2 infected ICU patients but the pathobiological mechanism is still under debate. Here two cases are described with an acute crystal-proven gout during admission on our ICU department for COVID-19 while on hypercaloric feeding, having a low serum rate, but clearly no history of previous gout.

Keywords: Acute Respiratory Distress Syndrome; Arthritis; COVID-19; Gout

References

  1. Marchetti C., et al. “Targeting of the NLRP3 Inflammasome for early COVID-19”. Bio Rxiv (2020).
  2. Aouba A., et al. “Targeting the inflammatory cascade with anakinra in moderate to severe COVID-19 pneumonia: case series”. Annals of the Rheumatic Diseases (2020).
  3. Cauchois R., et al. “Early IL-1 receptor blockade in severe inflammatory respiratory failure complicating COVID-19”. Proceedings of the National Academy of Sciences of the United States of America 117 (2020): 18951-18953.
  4. Huet T., et al. “Anakinra for severe forms of COVID-19: a cohort study”. Lancet Rheumatology7 (2020): e393-e400.
  5. Cavalli G., et al. “Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study”. Lancet Rheumatology6 (2020): e325-e331.
  6. Janssen C., et al. “Anakinra for the treatment of acute gout flares: A Randomized, Double-blind, placebo-controlled, active comparator, non-inferiority trial 2012”. Rheumatology 58 (2019): 1344-1352.
  7. Klück V., et al. “Dapansutrile, an oral selective NLRP3 inflammasome inhibitor, for treatment of gout flares: an open-label, dose adaptive, proof-of-concept, phase 2a trial”. The Lancet Rheumatology (2020): e270-280.
  8. Dalbeth N and Robinson PC. “Patients with gout: an under-recognised group at high risk of COVID-19”. Lancet Rheumatology (2020).
  9. Schlesinger N., et al. “Serum urate during acute gout”. The Journal of Rheumatology6 (2009): 1287-1289.
  10. Waldron JL., et al. “The effect of the systemic inflammatory response, as provoked by elective orthopaedic surgery, on serum uric acid in patients without gout: a prospective study”. Rheumatology 52 (2013): 676678.
  11. Cavalli G., et al. “Interleukin-1 and interleukin-6 inhibition compared with standard management in patients with COVID-19 and hyperinflammation: a cohort study”. Lancet Rheumatology (2021).
  12. Salvatierra J., et al. “Interleukin-1 and interleukin-6 inhibition in patients with COVID-19 and hyperinflammation”. Lancet Rheumatology (2021).
  13. Neogi T., et al. “2015 Gout classification criteria: an American College of Rheumatology / European League Against Rheumatism collaborative initiative”. Annals of the Rheumatic Diseases 74 (2015): 1789-1798.
Citation: Tim L Th A Jansen., et al. “Severe Covid-19 is a Risk Factor for Gout Even in Hypouricaemic ICU Patients. Sign of Arousal of NLPR3 Activation?”. EC Orthopaedics 12.7 (2021): 33-38.

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