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Challenges in the management of patients with systemic light chain (AL) amyloidosis during the COVID-19 pandemic

Kastritis, E; Wechalekar, A; Schoenland, S; Sanchorawala, V; Merlini, G; Palladini, G; Minnema, M; ... Dimopoulos, MA; + view all (2020) Challenges in the management of patients with systemic light chain (AL) amyloidosis during the COVID-19 pandemic. British Journal of Haematology , 190 (3) pp. 346-357. 10.1111/bjh.16898. Green open access

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Abstract

Summary: The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)‐associated coronavirus disease 2019 (COVID‐19) is primarily manifested as a respiratory tract infection, but may affect and cause complications in multiple organ systems (cardiovascular, gastrointestinal, kidneys, haematopoietic and immune systems), while no proven specific therapy exists. The challenges associated with COVID‐19 are even greater for patients with light chain (AL) amyloidosis, a rare multisystemic disease affecting the heart, kidneys, liver, gastrointestinal and nervous system. Patients with AL amyloidosis may need to receive chemotherapy, which probably increases infection risk. Management of COVID‐19 may be particularly challenging in patients with AL amyloidosis, who often present with cardiac dysfunction, nephrotic syndrome, neuropathy, low blood pressure and gastrointestinal symptoms. In addition, patients with AL amyloidosis may be more susceptible to toxicities of drugs used to manage COVID‐19. Access to health care may be difficult or limited, diagnosis of AL amyloidosis may be delayed with detrimental consequences and treatment administration may need modification. Both patients and treating physicians need to adapt in a new reality

Type: Article
Title: Challenges in the management of patients with systemic light chain (AL) amyloidosis during the COVID-19 pandemic
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/bjh.16898
Publisher version: https://doi.org/10.1111/bjh.16898
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Hematology, amyloidosis, COVID-19, hydroxychloroquine, tocilizumab, remdesivir, PROGNOSTIC-FACTORS, RENAL-RESPONSE, HYDROXYCHLOROQUINE, RISK, CYCLOPHOSPHAMIDE, DARATUMUMAB, OUTCOMES, INJURY
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10114084
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