Does methotrexate influence COVID-19 infection? Case series and mechanistic data

Schaelter F, Dürholz K, Bucci L, Burmester G, Caporali R, Figuereido C, Cobra JF, Manger B, Zaiss M, Schett G (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Book Volume: 23

Article Number: 166

Journal Issue: 1

DOI: 10.1186/s13075-021-02464-4

Abstract

Background: To investigate whether methotrexate treatment may affect the susceptibility to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: Clinical assessment of symptoms, SARS-CoV-2 RNA, and anti-SARS-CoV-2 IgG in an initial case series of four families and confirmatory case series of seven families, within which one family member developed coronavirus disease 19 (COVID-19) and exposed another family member receiving methotrexate treatment; experimental part with methotrexate treatment of mice and organoids followed by the assessment of mRNA and protein expression of the SARS-CoV-2 receptor angiotensin-converting enzyme (ACE)-2. Results: In the initial case series, three of four women on a joint ski trip developed COVID-19, while the fourth woman, under treatment with methotrexate, remained virus-free. Two of the three diseased women infected their husbands, while the third husband treated with methotrexate remained virus-free. In addition, 7 other families were identified in a follow-up case series, in which one member developed COVID-19, while the other, receiving methotrexate, remained healthy. Experimentally, when mice were treated with methotrexate, ACE2 expression significantly decreased in the lung, in the intestinal epithelium, and in intestinal organoids. Conclusion: These clinical and experimental data indicate that methotrexate has certain protective effects on SARS-CoV-2 infection via downregulating ACE2.

Authors with CRIS profile

Involved external institutions

Università degli studi di Milano Italy (IT) Charité - Universitätsmedizin Berlin Germany (DE) Cobra Reumatologia Brazil (BR)

How to cite

APA:

Schaelter, F., Dürholz, K., Bucci, L., Burmester, G., Caporali, R., Figuereido, C.,... Schett, G. (2021). Does methotrexate influence COVID-19 infection? Case series and mechanistic data. Arthritis Research & Therapy, 23(1). https://doi.org/10.1186/s13075-021-02464-4

MLA:

Schaelter, Fabian, et al. "Does methotrexate influence COVID-19 infection? Case series and mechanistic data." Arthritis Research & Therapy 23.1 (2021).

BibTeX: Download