Uncertainties surrounding COVID-19 have been a focal point of stress for people all over the world. Mandatory quarantine and limited outlets for socialization can cause negative health benefits including emotionally, mentally, and even physically. Being stuck at home for days on end can give rise to feelings of anxiety, distress, and depression. For those affected by autoimmune disorders, like many rheumatic conditions, this pandemic has even greater potential to disrupt the normality of everyday life.
In 2005, the US Department of Health and Human Services indicated that autoimmune disorders affect between 15 and 23.5 million individuals in the US alone. This statistic showed that the prevalence was rising steadily, so today that number is likely to be higher.
With that in mind, there could now be over 25 million immunocompromised people nationwide. The Center for Disease Control considers these individuals at high risk for contracting Covid-19. Beyond that, individuals who are over 65-years old, live in long-care facilities, have HIV, asthma, liver disease, diabetes, or heart disease are considered at higher risk for developing severe symptoms.
COVID & Autoimmune Conditions
A population study performed by the American College of Rheumatology found that patients living with RA have a greater risk for developing infections compared to the general population. Another study published in the Journal of Rheumatology provided evidence showing that patients who received immunosuppressants were 4 times more likely to develop a serious infection.
These immunosuppressant drugs, commonly corticosteroids, inhibit the immune system’s ability to function properly, which reduces the occurrence of inflammation. This is seen as a positive effect for rheumatic patients who struggle with pain from inflammation. However, while a virus is spreading through the population, it leaves those patients at greater risk of contracting the virus. A suppressed immune system is unable to fight the attacking virus, leaving the body susceptible to a viral infection.
So what does this mean for you? Essentially, if you’re living with, or know someone living with rheumatic conditions, you (or they) have a higher risk of developing Covid-19.
How Can I Protect Myself Against COVID with an Autoimmune Condition?
To reduce your chances of contracting the virus, wash your hands often with soap and water for at least 20 seconds. Do not touch your face, eyes, or mouth with unwashed hands. Avoid leaving your home as much as you can. If you have friends or family members who can help you get groceries and other supplies, you can significantly reduce your risk of getting the virus. When you do make trips outside, always practice social distancing and definitely wear a facemask. In your home, clean and disinfect surfaces you touch often such as doorknobs, lights, toilets, sinks, kitchen appliances, tables, phones, and other electronics.
Furthermore, patients receiving medication can speak to a pharmacist or doctor to inquire about receiving an emergency supply of medications. There may also be methods of obtaining medications via mail to reduce public exposure.
Individuals can refer to the CDC’s list of preventative measures to follow for immunocompromised individuals or those taking medications leading to a suppressed immune system.
Are You Worried About Going To The Doctor’s Office?
The CDC recommends keeping all of your regularly scheduled appointments. While going for a doctor’s visit, practice all the safety measures mentioned above. It’s important to remember that doctors know the risks and are doing everything they can to manage them. Doctors would not ask patients to come for a visit if they thought it would put them, or their patients, at too great of a risk. Hospitals, doctor’s offices, and other clinics have adapted their procedures and environment to reduce the spread of the virus.
Additionally, some doctors are offering telehealth visits, which may come in the form of a video call or phone call. Speak to your doctor to see if this is a readily available option.
Beyond scheduled visits, it’s important to keep your doctor up to date with any concerns or complications that may arise. If you begin to feel unwell, seek care urgently.
Wondering What To Do About Your Medications?
Unless directed by a doctor, continue taking your medications as prescribed. Doing so will reduce the risk of disease flare-ups that would otherwise increase the risk of contracting the virus.
If you receive infusions for conditions like Rheumatoid Arthritis, speak with your doctor regarding appointments. Medical staff may recommend additional safety precautions that patients should take when coming in for appointments.
In April, the American College of Rheumatology released a guide for managing rheumatic conditions during the pandemic. The guide presents a comprehensive list of scenarios for patients and doctors to consult regarding medication usage.
Feelings of anguish, stress, and depression are common during world-wide emergencies such as this. Taking care of your mental and emotional health is just as important as taking care of your physical health.
If you’re living with or have family members, loved ones, or friends nearby, speak openly about your concerns. The group of people you’re surrounded by can help get groceries, medications, and anything else you need. The knowledge of having support from others can be incredibly comforting in these times.
While spending most of your time indoors, activities like stretching, yoga, or light exercise can be extremely beneficial physically, mentally, and emotionally. Working one or multiple of these into your daily routine can help keep anxiety, stiffness, and fatigue at bay.
Some other tips to improve your overall well-being include:
- Maintaining a health
According to Harvard researchers, foods such as tomatoes, olive oil, green leafy vegetables (kale, spinach, collards), nuts, fatty fish (salmon, mackerel, tuna, sardines), and fruits (strawberries, blueberries, cherries, oranges) all have natural anti-inflammatory properties. Researchers also point out how eating a healthy diet can improve mood and overall quality of life.
Spices like turmeric, rosemary, and ginger may also possess anti-inflammatory properties. Foods to avoid eating include fried foods, soda, lard, processed meat, and sugary foods. These foods increase inflammation within the body.
- Adhering to a regular sleep schedule
The importance of sleep cannot be emphasized enough. Following a regular sleeping schedule, meaning going to bed and waking up at the same time every day, can help strengthen your immune system because your body produces T-cells and cytokines while you’re asleep.
- Practicing meditation
Researchers been providing international evidence for the benefits of meditation. Harvard researchers found meditation can help combat depression-related symptoms. Other various studies have found meditation can reduce stress and anxiety, promote a positive outlook on life, help fight addictions, improve sleep, control pain, and even reduce inflammation caused by stress.
Some patients may find activities such as learning an instrument, journaling, playing video games, or board games as ways to reduce stress. Whatever your tried and trusted method is, take the time to care for your mental well-being!
Review of Coronaviruses and Immunosuppressed Individuals
In March, an Italian researcher published an article in the American Association for the Study of Liver Diseases. This study reviewed past and present coronaviruses and the effects on immunosuppressed patients. These viruses include SARS-CoV, from the 2002 viral infection in China, MERS-CoV, a Middle East respiratory coronavirus, and Covid-19, the current virus affecting the world.
The primary researcher, Dr. D’Antiga, found that immunosuppressed patients are not at greater risk for severe complications compared to the general population. However, this is only specific to the family of coronaviruses, not all viruses. Dr. D’Antiga reviewed statistics from all the past coronaviruses to conclude that those with risk factors such as old age, obesity, diabetes, and other comorbidities were more likely to develop severe pulmonary disease.
This paper does not say rheumatic patients and other immunosuppressed patients are not at increased risk for contracting Covid-19; it only says they do not have an increased risk for severe pulmonary disease as a result of contracting Covid-19. All individuals should still practice social distancing and all other preventative measures.
Regardless, those who are immunocompromised may find some comfort in these findings. There is a light at the end of the tunnel for COVID and autoimmune conditions. With a little positivity and the proper precautionary measures, we’ll safely make it through this experience.