Autoimmune and coronavirus updates

The information below is based on the latest information and research available as of April 9th, 2020. As you know COVID-19 information changes frequently as new research is done. Please discuss your medications, autoimmune conditions and risk with your healthcare provider.

RISK CALCULATOR: Assessing your risk – rheumatology patients: Some people are more vulnerable to the new coronavirus, COVID-19 than others. If you have an autoimmune condition and/or if you are receiving treatment to control your immune system your risk from COVID-19 is higher. VERSUS ARTHRITIS

DIABETES KNOW YOUR RISK:  There is no evidence to date that people with diabetes are at increased risk of being infected with COVID-19.  However, people with diabetes, especially the elderly, can experience more severe symptoms and are more likely to need hospitalisation if they are infected with COVID-19. DIABETES AUSTRALIA

Young people with type 1 diabetes - Data from Wuhan (China) and Italy has found no evidence that children or young people with type 1 diabetes who develop COVID-19 experience severe symptoms of the disease.

Adults with type 1 diabetes or type 2 diabetes - If you’re living with diabetes and you develop a viral infection, such as COVID-19, it can be harder to treat and you may be at higher risk of serious complications.

Older people with diabetes, and people who have diabetes complications such as heart or kidney disease, may experience more severe symptoms of COVID-19.COVID-19 & IBD Medication: You probably have questions about your IBD medications and wonder if they increase your risk for contracting SARS-CoV-2 and developing COVID-19. Information at CROHN'S & COLITIS FOUNDATION

LUPUS and (COVID-19) frequently asked questions: It’s important that you emphasize to your friends, colleagues, neighbours, and anyone who might come in frequent contact with you or your environment that lupus puts you at higher risk from infections like coronavirus. This will let them know to be very careful with their own hygiene and health habits to ensure they don’t put you at further risk. LUPUS FOUNDATION OF AMERICA

MULTIPLE SCLEROSIS: Guidance for the use of disease modifying therapies during the COVID-19 pandemic. Information from THE NATIONAL MS SOCIETY (USA)

MYOSITIS: Dr. Rohit Aggarwal, Associate Professor of Medicine, Medical Director, Arthritis and Autoimmunity Center from the University of Pittsburgh, and Chair of The Myositis Association’s Medical Advisory Board recommends that myositis patients, particularly those on immunosuppressive drugs or older than 60 years of age, should take common sense steps and follow CDC recommendations such as frequent hand washing and avoiding sick contacts (including friends or family), avoiding touching your eyes, nose and mouth, covering your cough and sneezes and staying home when you are sick. Dr. Aggarwal also recommends avoiding non-urgent long-distance travel for patients on multiple immunosuppressive medications at this time. THE MYOSITIS ASSOCIATION

CELIAC DISEASE: The Celiac Disease Foundation Medical Advisory Board states that celiac disease patients in general are not considered to be immunocompromised. A small proportion of celiac disease patients with severe malnutrition and weight loss, the rare complication of Type 2 refractory celiac disease, on immunosuppressive medications, or with other serious illnesses, may be at increased risk of severe illness from COVID-19 and should consult with their physicians.

SJOGREN'S SYNDROME: For you, as a Sjögren’s patient, the key is not to panic but to take care of yourself. You are not more susceptible to becoming infected by the coronavirus than others, but if you do get diagnosed as being positive with COVID-19, the complications from COVID-19 may be more severe. Your risk of severe disease may be higher if you have a weakened immune system which may be the case for older people, people with other chronic diseases such as diabetes, cancer, heart, renal or chronic lung disease. Please note though, that not all Sjögren’s patients have compromised immune systems. However, some medications commonly taken by Sjögren’s patients may suppress the immune system, including  Arava (leflunomide), Imuran (azathioprine), cyclophosphamide, methotrexate, prednisone, Solu-Medrol (methylprednisolone), CellCept (Mycophenolate mofetil), and Rituxan (Rituximab). Plaquenil (hydroxychloroquine), on the other hand, does not suppress the immune system. Leslie P. Laing President: Sjögren’s Society of Canada

VASCULITIS: The specific risks of COVID-19 in people with vasculitis are yet to be determined. We suspect our patients are at higher risk of infection due to immunosuppression used to manage vasculitis. So far, we do not know whether the risk differs based on the type of immune-suppressing medication someone is taking. We also do not yet have data on the clinical course of patients with vasculitis who develop infection with COVID-19.

All patients with vasculitis (especially those on treatment) should consider themselves at high risk. They should take all the recommended precautions recommended by the Center for Disease Control (CDC) to minimize exposure. THE VASCULITIS FOUNDATION

CDC’s list of those at high-risk for severe illness from COVID-19 includes:

• People 65 years or older
• People who live in a nursing home or long-term care facility
• People of all ages with underlying medical conditions, especially if they are not well controlled
  • Chronic lung disease or moderate to serve asthma
  • Serious heart conditions
  • Conditions that cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications
• Severe obesity (body mass index [BMI of 40 or higher)
• Diabetes
• Chronic kidney disease and who are undergoing dialysis
• Liver disease