COVID-19 & Rheumatic Diseases
FAQ on COVID-19 & Rheumatic Diseases
If I have a rheumatic disease on immunosuppressive treatment with no symptoms of infection, should I stop my medicine to lower my risk of getting COVID-19?
In general, you are advised to continue your medicine as prescribed and should stay home and away from people as much as possible. You should practice frequent and thorough hand washing, including the use of hand sanitizers, and avoid touching of mouth, nose, or eyes with bare hands/fingers.
Don’t stop or change your treatment without checking with your rheumatologist.
I work in an office with a high number of co-workers. Should I stay away from work? Should I ask to work from home?
Patients at high risk for COVID-19 and likely to be exposed to crowded conditions (e.g., an office) should be advised to ask their employer for special accommodations, including option of remote work, etc.
I live with someone who is at high risk for acquiring COVID-19. What precautions should I take?
For close/household contacts of individuals with high risk for COVID-19 exposure (e.g., frontline health care workers), continuous evaluation of risk and standard measures to reduce transmission are recommended.
If I have symptoms like fever or cough, should I stop my medication?
Yes, if you have any symptom that may be related to COVID-19, you should stop your immunosuppressive treatment (except cortisone & Hydroxychloroquine ) and get tested for COVID-19 according to your local national guidelines.
Replace NSAIDs with paracetamol.
Check with your rheumatologist about the adequate timing to go back to your treatment.
What is known about the rate and severity of infection in patients with rheumatologic disease, especially those patients taking prednisone, DMARDs, biologics, or other immunosuppressive agents?
Prednisone (Cortisone) ≥ 20 mg/d , Azathioprine (Imuran®), Leflunomide (Arava® / Avara®), Mycophenolate mofetil (CellCept®, Myora®), Tacrolimus (Prograf®), Cyclophosphamide (Endoxan®), Methotrexate, Biologic therapies treatments like: Adalimumab (Humira®), Etanercept (Enbrel®), Certolizumab pegol (Cimzia®), Golimumab (Simponi®), Abatacept (Orencia®), Secukinumab (Cosentyx®), Tocilizumab (Actemra®), Ustekinumab (Stelara®) , Infliximab (Remicade®), Rituximab (MabThera®) & Belimumab (Benlysta®), Janus kinase (JAK) inhibitors (Xeljanz®, Olumiant®), Biosimilar to Infliximab (Remsima®) , Biosimilar to Adalimumab (Amgevita®) and Biosimilar to Rituximab (Truxima®)
Currently, there are no specific data on COVID-19 in patients with rheumatologic disease. Some anti-rheumatic drugs are in fact being tested for the treatment of COVID-19.
Are any pharmacologic measures (prophylactic or therapeutic) recommended?
There are currently no prophylactic or therapeutic measures beyond supportive care recommended for this virus.
What can patients do to protect themselves against contracting this disease?
Importance of hand hygiene, with frequent and effective hand washing, as well as avoidance of people who are ill, especially those who are coughing or sneezing.
The routine wearing of masks is encouraged to all individuals.
What can patients and their providers do?
Patients must receive all appropriate vaccinations, including seasonal influenza, pneumonia, pertussis, and shingles vaccines.
These will not prevent COVID-19 but may lessen the chance of a secondary infection and will prevent illnesses that could be confused with COVID-19.
Patients should employ frequent handwashing and in general avoid touching their face or mucous membranes.
In addition, patients should be advised to keep ample stocks (e.g., one-month supply) of necessary medications on hand in case they are prevented from refilling prescriptions in a timely manner.
Can we use Hydroxychloroquine for the prevention of COVID19?
No, only social distancing and good personal hygiene can prevent COVID-19.
Have biologic medication been used to treat COVID-19 infections?
Some biologic medications have been used experimentally in the setting of severe COVID-19 infection in an attempt to reduce the inflammatory response. However, there is no evidence to suggest that these medications treat or provide protection from infection with COVID-19.
If I’m taking a biologic treatment, am I considered immunocompromised?
How can I increase my immunity?
Eat healthy, practice exercise, drink plenty of water.
If I have no symptoms of infection, should I get tested for COVID-19?
You should only get tested if you have symptoms and follow your national guidelines for testing.
What the basic protective measures against the new coronavirus (COVID-19) for patients
You should practice thoroughly the general recommendations:
- Wash your hands frequently
- Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water (at least 20 seconds).
- Avoid touching eyes, nose and mouth
- Practice respiratory hygiene
- Make sure you, and the people around you, follow good respiratory hygiene by covering your mouth and nose with your bent elbow or tissue when you cough or sneeze.
- Maintain social distancing
- Maintain at least 1-meter distance between yourself and anyone.
- Avoid busy public transport
- Avoid large groups gatherings
- Avoid unnecessary travel
Do I need to put regularly a mask?
Mask It is strongly recommended for healthy individuals including patients with rheumatic diseases to wear a mask to prevent any contamination from infected asymptomatic individuals or those showing highly suspected symptoms of COVID-19.
Before putting on a mask, clean hands with alcohol-based hand rub or soap and water. If you wear a mask, then you must know how to use it and dispose it properly.
If you have fever, cough and difficulty breathing
Seek medical care immediately. Check with your rheumatologist if you have any question!