Autoimmune diseases in the era of COVID-19


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By Mutahir Abidi, MD


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Millions of Americans take medications to suppress their immune system to treat an autoimmune disease, like rheumatoid arthritis (RA) or lupus. Out of fear of contracting the COVID-19 virus, these patients may be tempted to stop taking these medications to boost their immunity. However, this is a decision that requires thoughtful discussion with your physician.


For people with autoimmune diseases, the issue isn’t that they have a weakened immune system. Instead, it’s that they have an overactive immune system that attacks the body’s joints or tissues because it thinks they are foreign substances. To counteract this hyperactivity, patients often are prescribed immunosuppressive medications to ratchet down their immune systems and stop the attack.


Types of RA Medications


There are several types of immunosuppressant medications prescribed to treat RA and other autoimmune diseases:


·         Disease-modifying anti-rheumatic drugs (DMARDS), which include Methotrexate and Plaquenil

·         Prednisone, a type of steroid used to control disease flare-ups

·         Biological agents, which include Enbrel, Remicade, Xeljanz, and Actemra

Does Taking an Immunosuppressant Increase My Risk for Coronavirus?

COVID-19 starts as a viral infection and then causes our immune system to overact, attacking the lungs and other organs. While no data at this point shows that people with autoimmune diseases are at higher risk of becoming infected with COVID-19, sometimes medication can suppress the immune system more than it should, increasing the risk of developing any type of infection. Most patients with autoimmune diseases do not develop infections, but several factors can make you more susceptible to infection, including:

·         The medication dose is too high

·         The type of medication you take

·         You’re genetically predisposed to developing infections

·         You have other medical conditions, like diabetes, heart disease, or kidney disease

·         Your age

In general, it is not recommended that those with autoimmune diseases stop taking their medication unless advised by their doctor. In fact, being in an active stage of your autoimmune disease may increase your risk of contracting COVID-19, so your medication may be an important tool in decreasing your risk. But, because every patient is different, it’s important to speak to your physician about your specific condition before you make any changes. Don’t rely on information you read online or hear on the news; your doctor knows your condition better than anyone else.

Taking Precautions

I recommend that all of my patients regardless of which medication they’re on to take extra precautions during this crisis. This includes:
·         Staying 6 feet apart from those you aren’t currently living with

·         Washing your hands thoroughly and frequently

·         Asking those who live with you to take the same precautions as listed above

·         Taking vitamin C supplements or eating foods high in vitamin C

·         Eating a healthy diet that is low in carbohydrates, fat, and sugar, and high in lean protein, fruits, and vegetables

·         Getting enough sleep

·         Managing stress and anxiety with exercise, meditation, or yoga

·         Avoiding alcohol and illicit drugs

This crisis is taking a mental toll on us all. If you’re having trouble coping, reach out to your primary care physician or call CentraState’s 24-Hour Crisis Hotline at 732-780-6023.

Lastly, if you have RA or any other autoimmune disease, it’s extremely important to be in contact with your doctor. He or she can see you via video visit, call in medication refills, write prescriptions for bloodwork, or can see you in the office if you need an injection or other treatment to manage your condition.

Mutahir Abidi, MD, is a board-certified rheumatologist and medical director of the Arthritis and Rheumatology Center at CentraState Medical Center. He can be reached by calling 866-CENTRA7.

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