Anti-MDA-5-positive dermatomyositis associated rapidly progressive interstitial lung disease, a virus-triggered autoimmune-like symptom?

Dear Editor, Virus infections have long been considered as a potent trigger for the development or the exacerbation of autoimmune disease [1]. The outbreak of coronavirus disease 2019 (COVID-19) prompts us to rethink the pathophysiology of certain autoimmune diseases, for instance, anti-melanoma differentiation-associated gene 5 positive DM (anti-MDA5+ DM) [2]. MDA5+ DM is typically amyopathic and associated with a life-threatening, therapy-resistant, rapidly progressive interstitial lung disease (RP-ILD). These clinical scenarios resemble COVID-19 lung involvement. Moreover, similar to cytokine storm in severe COVID-19 pneumonia, the increased levels of multiple cytokines, such as Cutaneous T cell Attracting Chemokine (CTACK), IFNγ, IL-8, Monocyte chemoattractant protein-1 (MCP-1), Monocyte chemoattractant protein-3 (MCP-3) and Stem cell growth factor-beta (SCGFβ), were observed in anti-MDA5+ DM RP-ILD patients of our cohort and are associated with poor outcome, consistent with previous reports [3, 4]. The similarity of these two...