COVID-19 and inflammatory rheumatic disease: Some key issues answered

Current data suggest patients with inflammatory rheumatic conditions do not exhibit an increased frequency of COVID-19 infection or a more severe course of disease. Risk factors such as older age, obesity, etc, seem more important.

The currently available data suggest that patients with inflammatory rheumatic conditions do not exhibit an increased frequency of COVID-19 infection or a more severe course of the disease in general. General risk factors – such as older age, obesity, cardiovascular conditions, chronic lung conditions, hypertension, and diabetes – seem to be much more important in this respect.

During a unique virtual press conference, Prof. Gerd Burmester (EULAR Public Affairs Officer; Charité University Hospital, Germany) addressed some issues regarding medication, inflammatory rheumatic disease, and COVID-19 infection [1]. He emphasized that discontinuing immunomodulatory medication is not a good idea, as patients with inflammatory rheumatic disease do not have an increased frequency of infection with COVID-19 nor experience a more severe course of the infection. Moreover, stopping therapy may trigger a relapse of the disease, which may lead to an unfavorable immunological situation or subsequent increased administration of cortisone, which has its specific hazards.

Prof. Burmester subsequently debunked the myth on the use of hydroxychloroquine in COVID-19 prevention or treatment, stating that some studies that investigated the drug were either uncontrolled or that the drug was given with concomitant medication. Also, hydroxychloroquine was administered in patients with pre-existing conditions and cardiovascular comorbidities; these results can therefore not be transferred to the common situations when treating autoimmune disorders.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, were initially thought to pose a danger to patients with COVID-19, but this has found not to be the case. Thus, NSAIDs can continue to be used. Similarly, it is important to know that angiotensin-converting enzyme (ACE) inhibitors, which are frequently used to treat hypertension for patients with a condition such as rheumatoid arthritis, are safe for patients infected with COVID-19. Moreover, current discussion focuses on a potential beneficial effect of these drugs on this condition.

Source:
1. Burmester G. Immunosuppressants, Analgesics and Anti-Inflammatory Drugs: Three common myths COVID-19 and Medication Used in Rheumatology – Current Findings. EULAR E-Congress, 3-6 June 2020.

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