Autoinflammatory Disease during Covid-19

Epidemiological investigation of COVID-19 in autoinflammatory diseases. Protected confidentiality. Do You agree?

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1. Identity (Obbligatorio)

F (female)

M (male)

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2. Age (Obbligatorio)

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3. Date of Covid-19 diagnosis (Obbligatorio)

Date

Data

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4. Autoinflammatory disease (Obbligatorio)

Familial Mediterranean Fever

TRAPS

Cryopyrin-associated periodic syndrome- CAPS

Hyper IgD syndrome - Mevalonate kinase deficiency

Still's disease

Recurrent pericarditis

PFAPA (periodic fever, aphthous stomatitis, adenitis)

Other (specify) for more information visit the web site: http://rita.ern-net.eu//rare-diseases/#aid-tab

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5. Treatment (Obbligatorio)

Colchicine

Anakinra - (Kineret)

Canakinumab - (Ilaris)

Steroids - (prednisone/dexamethasone)

None

Other (specify )

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6. Colchicine dose, mg (Obbligatorio)

0.5

1.5

more than 2 mg (specify)

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7. Symptoms (Obbligatorio)

Fever

Cough

Dyspnea

Loss of taste

Smell loss

Fatigue - Asthenia

Muscle aches - myalgia

Gastrointestinal symptoms (e.g. diarrhea, nausea)

Headache

Other (specify)

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8. Severity (Obbligatorio)

Fever only >37.5 °C

Home isolation with symptomatic treatment

Hospitalization less than 1 month

Hospitalization over 1 month

Hospitalization in the intensive care unit

Mechanical ventilation

Death

Other (specify)

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9. Other diseases (Obbligatorio)

Obesity

Hypertension

Asthma

Chronic bronchitis

Diabetes mellitus

Cardiopathy

Other (specify)

Autoinflammatory Disease during Covid-19

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* 1. Identity (Obbligatorio)

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* 2. Age (Obbligatorio)

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* 3. Date of Covid-19 diagnosis (Obbligatorio)

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* 4. Autoinflammatory disease (Obbligatorio)

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* 5. Treatment (Obbligatorio)

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* 6. Colchicine dose, mg (Obbligatorio)

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* 7. Symptoms (Obbligatorio)

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* 8. Severity (Obbligatorio)

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* 9. Other diseases (Obbligatorio)

1. Identity (Obbligatorio)

2. Age (Obbligatorio)

3. Date of Covid-19 diagnosis (Obbligatorio)

4. Autoinflammatory disease (Obbligatorio)

5. Treatment (Obbligatorio)

6. Colchicine dose, mg (Obbligatorio)

7. Symptoms (Obbligatorio)

8. Severity (Obbligatorio)

9. Other diseases (Obbligatorio)