Drs. Cron and Chatham reply
Randy Q. Cron, Winn Chatham
Abstract
To the Editor: We appreciate our Italian colleagues’ interest in our editorial denoting the rheumatologist’s role in helping to diagnose and treat cytokine storm syndrome (CSS) in the setting of the coronavirus disease 2019 (COVID-19) pandemic1. It is encouraging that none of the 123 pediatric rheumatology patients (primarily juvenile idiopathic arthritis) treated with background biological disease-modifying antirheumatic drug (bDMARD) therapies in Milan, Italy, surveyed over a 7-week period from February 25 through April 14, 2020 (during which time COVID-19 was hyperendemic there), had either confirmed or suspected COVID-192. Moreover, 67% of this cohort were concomitantly taking conventional DMARD (e.g., methotrexate), and 5% were taking systemic corticosteroids2. This lack of symptomatic infection with SARS-CoV-2 (viral etiology … Address correspondence to Dr. R.Q. Cron, Children’s of Alabama, Division of Rheumatology, 1600 7th Ave. S., CPPN, Suite G10, Birmingham, AL 35233-1711, USA. E-mail: rcron{at}peds.uab.edu.