The Department of Medicine at Hospital for Special Surgery has put together the following guidance for people with rheumatic disease concerning the virus that causes COVID-19.
People with rheumatic disease may be at greater risk of developing infections and more severe infections, although we don’t know this for sure yet. This is due to the diseases themselves and to the medications used to treat these diseases. This vulnerability can affect people with several rheumatic conditions, including: lupus, myositis, rheumatoid arthritis, scleroderma, undifferentiated connective tissue disease, vasculitis and many others.
Other people who may be predisposed to developing serious cases of COVID-19 include those who are aged 65 years or older, have diabetes (type 1 or type 2) or renal (kidney) disease, and women who are pregnant.
If you develop a fever, shortness of breath or a cough, particularly if you have travelled to areas with outbreaks or have been exposed to someone with COVID-19 infection, it is very important to communicate with your health care provider. Communication is particularly essential for older patients, those who are pregnant, those with underlying lung or heart disease and those on immunosuppressive drugs. We don’t advise walk-in visits: Unless you need to get to an emergency room with a true emergency, it is recommended that you call ahead – call your doctor, or an urgent care center, or your hospital – so that you can be advised on what to do and whether you need to be seen in person or not.
In patients without symptoms of COVID-19, the decision to stop or reduce immune suppressing medications is an individual one, to be shared by physician and patient. In some patients, the risk of a disease flare might outweigh the possible benefits of stopping medications. Little if anything is known about how rheumatology medications affect COVID-19 infections.
There has been, and this is a concern for the near future. See Hydroxychloroquine (Plaquenil) and Chloroquine Shortage Caused by COVID-19 Coronavirus Claims.
As with any respiratory illness there are certain preventive measures that you can take. These include:
With respect to travel, we are advising many of our patients to limit or cancel unnecessary domestic and international travel. You may also wish to avoid crowded areas and large gatherings, public transportation and working remotely when possible. Immunosuppressed patients may want to reach out to their doctors for letter to work from home if need be.
Providing more specific recommendations for people with rheumatic diseases is difficult for two reasons: there is much that is not known, and the outbreak is changing rapidly.
However, you can find more detailed and up-to-date information about COVID-19 on the website of the Centers for Disease Control.
Updated: 3/15/2020