Sarcoidosis and COVID-19: At the Cross-Road between Immunopathology and Clinical Manifestation

Coronavirus disease 2019 (COVID-19) has been associated with dysregulation of the immune system featuring inappropriate immune responses, exacerbation of inflammatory responses, and multiple organ dysfunction syndrome in patients with severe disease. Sarcoidosis, also known as Besnier-Boeck-Schaumann disease, is an idiopathic granulomatous multisystem disease characterized by dense epithelioid non-necrotizing lesions with varying degrees of lymphocytic inflammation. These two diseases have similar clinical manifestations and may influence each other at multiple levels, eventually affecting their clinical courses and prognosis. Notably, sarcoidosis patients are at high risk of severe COVID-19 pneumonia because of the underlying lung disease and chronic immunosuppressive treatment. In this narrative review, we will discuss interactions between sarcoidosis and COVID-19 in terms of clinical manifestations, treatment, and pathogenesis, including the role of the dysregulated renin-angiotensin system, altered immune responses involving increased cytokine levels and immune system hyperactivation, and cellular death pathways.

Automated summary

COVID-19 and sarcoidosis are two diseases with similar clinical manifestations, and they may interact with each other in terms of immune system dysregulation, inflammatory response, and disease course. Sarcoidosis patients are at a higher risk of developing severe COVID-19 pneumonia due to underlying lung disease and immunosuppressive treatment. This review discusses the interactions between these two diseases in terms of clinical manifestations, treatment, and pathogenesis.