Sarcoidosis With COVID-19

Sarcoidosis  With  COVID-19

Attapon  Cheepsattayakorn1,3*, Ruangrong  Cheepsattayakorn2, Porntep  Siriwanarangsun3*

 

1. 10th  Zonal  Tuberculosis  and  Chest  Disease  Center, Chiang  Mai, Thailand.

2. Department  of  Pathology, Faculty  of  Medicine, Chiang  Mai  University, Chiang  Mai, Thailand.

3. Faculty  of  Medicine, Western  University, Pathumtani  Province, Thailand.


Correspondence to: Attapon  Cheepsattayakorn, 10th  Zonal  Tuberculosis  and  Chest  Disease  Center, 143  Sridornchai  Road  Changklan  Muang  Chiang  Mai  50100  Thailand Tel : 66  53  140767 ; 66  53  276364 ; Fax : 66  53  140773 ; 66  53  273590 ; Email :  Attapon1958@gmail.com 


Copyright

© 2024 Attapon  Cheepsattayakorn. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 03 January 2024

Published: 17 January 2024


Sarcoidosis With COVID-19

Several  post-COVID-19  inflammatory  disorders  and  autoimmune  diseases  have  been  discovered [1]  since  global  COVID-19  pandemic  started [2].  Association  between  these  diseases  is  still  to  be  investigated [2].  Common  genes  between  COVID-19  and  sarcoidosis  are  demonstrated  in  Figure 1, 2 [3].  Nevertheless, sarcoidosis  organ  involvement, demographics, and  type  of  sarcoidosis  treatment  at  the  time  of  COVID-19  diagnosis  are  related  to  hospital  admission, non-invasive  ventilation  or  high  flow  oxygenation, intubation [4].   A  retrospective  hospital-based  cohort  study  of  585  French  sarcoidosis  patients  in  2017, demonstrated  an  estimate  of  a  5 %  frequency  of  severe  infections  that  resulting  in  hospital  admission  and  death [5].  A typical HRCT feature in sarcoidosis is the presence of well-defined micronodules scattered along the broncho-vascular bundle, veins, fissures and pleura in a characteristic lymphatic distribution. Occasionally, “ galaxy  sign ”,a  highly  suggestive  of  pulmonary  sarcoidosis (predominance  of  a  mid-to-upper  lung  zones)  may  demonstrates  conglomerate masses that  are surrounded by a multitude of micronodules (Figure  3) [6].

Where VDR dominantly connected to 14 different kinds of drug, protein drug interaction network collected from DrugBank  provides  proper  treatment. Vitamin D and some of its analogous compounds might play significant roles in modulating both COVID-19 and sarcoidosis conditions  is  indicated  by  this  network (Figure  4) [3].

Besides  sarcoidosis  of  lungs, symptomatic  and  accidental  extrapulmonary  sarcoidosis  is  also  found  around  the  world (Figure  5, 6, 7) [7-9]. 

In  conclusion, hub  gene  identification  might  have  significant  roles  in  modulating  sarcoidosis  and  COVID-19  infection.  In  the  literature, cases  with  sarcoid-like  granuloma  have  been  reported  very  few.  Sarcoid-like  immune  response  to  COVID-19  could  be  noncaseating  granulomas  due  to  short  time  from  disease  to  develop  granuloma. 

 

Figure  1 :  Demonstrating  a Venn diagram of commonly differentially expressed upregulated genes. Common 34 upregulated genes were identified from 2320 upregulated genes of COVID-19 infection and 227 upregulated genes of sarcoidosis [3].

Figure  2 :  Demonstrating  protein-protein interactions (PPIs) network for common upregulated genes from COVID-19 and sarcoidosis. The light green color nodes indicate common upregulated genes. Network consists of 32 nodes and 102 edges [3].

Figure  3  :  Demonstrating  irregularly marginated nodule surrounded by multiple small nodules (“Galaxy sign”, yellow narrow), this is typical of sarcoidosis (a); ground-glass-like increased attenuation resulting from diffuse micronodules randomly distributed (“Miliary sarcoidosis”) (b); enlarged and partially calcified (yellow narrows) bilateral hilar lymph nodes (c); fibrotic sarcoidosis with cystic changes and traction bronchiectases (yellow narrows) predominantly in the perihilar region and upper lobes. Nodular abnormalities are minimal/absent, but the appearance and the location of the fibrosis are very suggestive of the diagnosis of sarcoidosis (d) [6].

Figure  4 :  Demonstrating  drugs protein interaction network [3].

Figure  5  :  Demonstrating  isolated  muscular  sarcoidosis, revealed by hypercalcemia and 18F-FDG PET/CT [7].

Figure  6  :  18F-FDG PET/MRI for Diagnosis and Treatment Efficacy Evaluation of Spinal Sarcoidosis [8].

Figure  7 :  Demonstrating  FDG PET of Isolated Right Ventricular Sarcoidosis [9].

 

References

1. Galeotti  C, Baryl  J.  Autoimmune  and  inflammatory  diseases  following  COVID-19.  Nat  Rev  Rheumatol  2020; 16 (8) : 413-414. 

2. Racil  H, Znegui  T, Maazoui  S, Touil  A, Habibech  S, Henda  N, et  al.  Can  coronavirus  disease  2019  induce  sarcoidosis : a  case  report.  Thorac  Res  Pract  2023; 24 (1) : 45-48. 

DOI : 10.5152/.ThoracResPract.2023.22076

3. Mogal  R, Sovupa  SA, Junayed  A, Mahmod  R, Abedin  Z, Sikder  S.  Common  genetic  aspects  between  COVID-19  and  sarcoidosis : a  network-based  approach  using  expression  data.  Biochemistry  and  Biophysics  Reports  2022; 29 : 101219. 

4. Nadeem  O, Sharma  A, Alaouie  D, Bradley  P, Ouellette  D.  Outcome  in  patients  with  sarcoidosis  diagnosed  with  COVID-19.  Presentation  at  Chest  2021  annual  meeting, October  2021, 17-20.

DOI :  https://doi.org/10.1016/j.chest.2021.07.1161  

5. Dureault  A, Chapelon  C, Biard  L, et  al.  Severe  infections  in  sarcoidosis : incidence, predictors  and  long-term  outcome  in  a  cohort  of  585  patients.  Medicine (Baltimore)  2017; 96 : e8846.

6. Bernardinello N, Petrarulo S, Balestro E, Cocconcelli E, Veltkamp M, Spagnolo P. Pulmonary Sarcoidosis: Diagnosis and Differential Diagnosis. Diagnostics (Basel). 2021 Aug 28;11(9):1558.

DOI : 10.3390/diagnostics11091558.  

7. Dhomps  A, Thibault  F, Streichenberger  N, Andrea  S, Jeremie  T. Isolated  muscular  sarcoidosis  revealed  by  hypercalcemia.  Clinical Nuclear Medicine 44(10):p 824-825, October 2019.

DOI: 10.1097/RLU.0000000000002678

8. Ashjan K, Darejan  B, Lea  F, Mathilde  H, Vincent  P, Imperiale, Alessio I. 18F-FDG PET/MRI for diagnosis and treatment efficacy evaluation of spinal sarcoidosis.  Clinical Nuclear Medicine 49(1):p e28-e30, January 2024. DOI: 10.1097/RLU.0000000000004968

9. Alan S, Dagmar  HS.  FDG PET of Isolated Right Ventricular Sarcoidosis.  Clinical Nuclear Medicine 48(2):p 184-185, February 2023. DOI: 10.1097/RLU.00000000000044013

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