In the epidemic of CORONA infection, we have to fight against this new villain but cannot compromise with previous Rheumatologic diseases.
• What is a Rheumatological disease?
It’s a group of diseases that are due to misdirected self-immunity. eg: Rheumatoid Arthritis, SLE, vasculitis. In regular language we call it as Arthritis, Saandhivaat, Aamvaat.
• What are immunosuppressive drugs?
These are drugs which are used to suppress misdirected immunity eg: Steroids, HCQs, Methotrexate
• Can CORONA infection make Rheumatological disease worse?
Any kind of viral infection can worsen rheumatological disease. Fortunately, till now there are no reports of CORONA infection worsening the rheumatological disease.
• Can rheumatological condition make it more likely to catch the CORONA virus?
Yes, if a rheumatological disease i.e inflammation is not under control, there are chances of getting an infection.
• Will immunosuppressive drugs used for rheumatological diseases increase chances of infection?
Yes, but chances can be reduced by using proper measures. On the other hand, if these immunosuppressive medicines are not used, then rheumatological disease itself will be aggravated and the chance of getting an infection will increase.
• Can we stop immunosuppressive drugs?
Never change rheumatological medicines without the consult of a physician/ Rheumatologist. Medicines have to be continued until you are suspected/ confirmed to be infected.
Pain Killers [NSAIDs]- If there is fever, body pain, we can safely try with Tab. Paracetamol. If there is no relief, we can use regular pain killers.
Prednisolone- Steroid- eg: T.Wysolone, Omnacortil, Deflazacort should not be stopped. On stopping, there will be a flare of rheumatological disease, and also the patient may suffer from the Addisonian crisis [sudden hypotension]. Even if there is a CORONA infection, it can be continued with dosage adjustments.
DMARDs [Methotrexate, Leflunomide], Biological drugs can be continued unless they are suspected/ proved for infection.
DMARDs [T.HCQ, T. Sulfasalaazine] can be continued even in the presence of infection.
Important points:
Avoid frequent hospital visits
Avoid crowding in hospital/ clinic
During visit, Accompany only one attender
Can communicate through telemedicine [Email, Video call, Whats’app]
Can try for home blood collection, home delivery of medicines
To conclude:
• General preventive measures will avoid CORONA infection and flare of Rheumatological disease.
• Do not stop any immune-suppressive medicines unless you have been told by doctor or you are suspected/ proved to be infected with CORONA infection.
• DMARDs like HCQ, Sulfasalazine can be continued even in the presence of infection.
• Avoid frequent hospital visit, continue care with Telemedicine.
• Eat well, rest well but do not neglect routine simple exercises.
• We will win over this crisis, but with efforts.
Dr. Praveen Jain, MD, DM
Consultant Immunologist & Rheumatologist, KLES Dr. Prabhakar Kore Hospital & MRC, Belagavi.
(M) 7821057906
