COVID-19 and severe cutaneous allergic reactions to sulfonamides.

Autor: Deng E; From the Section of Allergy, Asthma and Immunology, Department of Medicine, Pennsylvania State College of Medicine, Hershey, Pennsylvania and., Craig TJ; From the Section of Allergy, Asthma and Immunology, Department of Medicine, Pennsylvania State College of Medicine, Hershey, Pennsylvania and., Nguyen DV; Department of Allergy & Immunology Vinmec International Hospital, Times City, Hanoi, Vietnam., Al-Shaikhly T; From the Section of Allergy, Asthma and Immunology, Department of Medicine, Pennsylvania State College of Medicine, Hershey, Pennsylvania and.
Jazyk: angličtina
Zdroj: Allergy and asthma proceedings [Allergy Asthma Proc] 2024 Nov 01; Vol. 45 (6), pp. e93-e100.
DOI: 10.2500/aap.2024.45.240086
Abstrakt: Background: Sulfonamides are associated with severe cutaneous adverse reactions (SCARs). Coronavirus disease 2019 (COVID-19) triggers an immune response, which may increase the likelihood of developing a hypersensitivity reaction. Objectives: We sought to explore the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the probability of developing SCARs and/or erythema multiforme (EM) reactions to sulfonamides. Methods: In the propensity score-matched cohort study by using the de-identified TriNetX Research data base, patients who had an exposure to antibiotic or non-antibiotic sulfonamides between March 1, 2020, and January 1, 2023, were divided into two groups based on the presence or absence of a previous COVID-19 infection within 6 months of starting the sulfonamide agent. The outcomes studied were the 30-day risk of developing SCARs or EM (Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms, or EM) within 3 months of sulfonamide exposure. Cohorts were matched based on baseline demographics; malignant lymphoid neoplasms; human immunodeficiency virus; systemic lupus erythematosus; bone marrow transplantation; diabetes; psoriasis; seizures; gout; solid organ or stem cell transplantation; COVID-19 vaccination; and exposure to risk medications, including allopurinol, levetiracetam, carbamazepine, lamotrigine, oxcarbazepine, phenytoin, phenobarbital, abacavir, nevirapine, piroxicam, tenoxicam, or mexiletine. Results: When comparing 345,119 patients on sulfonamides and with previous COVID-19 to an equal number of sulfonamides users without a previous COVID-19, patients with COVID-19 had a lower risk of developing any form of SCARs (relative risk 0.39 [95% confidence interval, 0.26, 0.58]; p < 0.001). Conclusion: Previous SARS-CoV-2 infection seems to be associated with a lower probability of developing SCARs or EM among patients using sulfonamides.
Databáze: MEDLINE