Abstract
To the EditorNearly two years after the onset of the coronavirus disease 2019 (COVID-19) pandemic,
healthcare workers face new and unexpected complications. Although accelerating the
vaccination process in recent months has reduced the incidence and mortality of the
COVID-19 infection, the general population (particularly vulnerable groups) remains
at risk of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
variants. Over the last two months, Iran has encountered the fifth wave of the
COVID-19 pandemic, i. e., the B.1.617.2 (Delta) variant of the SARS-CoV-2,
with faster infectiousness and higher severity and mortality among hospitalized
patients 1. Although fever, cough, and
expectoration are the most common clinical features of COVID-19, recent studies have
indicated an increasing number of skin manifestation reports in the disease.
Besides, there is growing evidence that underlying SARS-CoV-2 infection may increase
the risk of adverse drug reactions 2.
However, the enduring concern in our medical centers in recent days is a raised
incidence of Stevens-Johnson syndrome (SJS) in recovered COVID-19 patients following
monotherapy with older antiepileptic drugs (0.004 vs. 0.0008% –
i. e., 5 times higher than the pre-COVID-19 period) 3. It is worth noting that these patients did
not have any history of SJS/toxic epidermal necrolysis (TEN) or additional
etiopathogenic factors, including infections, genetic factors (particularly
HLA-B*1502 allele), and malignancy. Furthermore, for many years before
developing the COVID-19 and recovering from it, they had been treated with the above
drugs without showing any cutaneous hypersensitivity reactions. These observational
findings raise two important questions: (i) Could a history of the COVID-19
infection be a potential risk factor for type IV hypersensitivity reactions to older
antiepileptic drugs? (ii) If so, what are its mechanisms of action?
Subject
Pharmacology (medical),Psychiatry and Mental health,General Medicine
Cited by
1 articles.
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