Living With RA: How to Protect Yourself From COVID-19

Medically Reviewed by Dany Paul Baby, MD on April 21, 2023
Written by Kara Mayer Robinson
6 min read

When you have rheumatoid arthritis (RA), you may have a higher risk of getting COVID-19 with severe symptoms.

Experts aren’t sure why, but it’s possible that RA makes infection more likely. Medications that suppress your immune system may also put you at a higher risk. Age and other underlying conditions may also play a role. If you get infected, your symptoms may be more severe.

To protect yourself from COVID-19, start with these basics:

  • Wash your hands often. Use soap and water for at least 20 seconds.
  • Try to keep your hands away from your face. Avoid touching your eyes, nose, and mouth.
  • If you don’t have soap and water, use a hand sanitizer with at least 60% alcohol.
  • Clean and disinfect frequently touched surfaces often.
  • Stay home when you can.
  • Wear a face mask when you go out in public.
  • Practice social distancing. Stay at least 6 feet away from others.
  • Avoid crowded areas, large gatherings, and public transportation.
  • Don’t go near people who are sick.
  • Have someone else do your grocery runs.
  • Get a 2- to 4-week supply of medicine, if possible.
  • Protect your immune system by preventing infections from other diseases. Talk to your doctor about vaccines for things like the flu, pneumonia, whooping cough, and shingles.

There are many more things you can do to limit your exposure and reduce your risk. Take these simple steps.

Most cases of COVID-19 are mild. So you may be able to get better at home. But because you have a higher risk, it’s important to talk to your doctor if you feel sick or were exposed to COVID-19. Call right away if you have a fever, shortness of breath, or a cough. Avoid walk-in visits unless it’s a true emergency. Call your doctor, urgent care center, or hospital to see if you should come in.

Other symptoms of COVID-19 include:

Free COVID testing is available in most communities. Some locations require an appointment while others are drive-up. Check with your local health department about testing availability. At-home tests are also available.

You may not get a fever, even if you're sick, when you're taking steroids, NSAIDs, or an immunosuppressant. Tell your doctor or rheumatologist if you have any of the above symptoms. They'll decide if you need to make any changes to your medicine or go to the hospital.

Your doctor may delay or stop certain treatment while you're sick. That includes biologics and DMARDs. If you're on steroids, they may lower your dose.

Call your doctor or 911 right away if you have:

  • A really hard time breathing
  • Constant chest pain or pressure
  • A new kind of confusion
  • A blue tint to your lips and face

While there are vaccines for the virus, there's no specific treatment as yet. But some researchers are studying whether certain RA drugs might help. They include:

  • Chloroquine
  • Hydroxychloroquine (Plaquenil)
  • Tocilizumab (Actemra)

Some studies found early evidence that hydroxychloroquine had an effect against the new coronavirus. But many of those trials were stopped when they found serious side effects or failed to show lasting results.

Based on early findings, the FDA issued an emergency ruling that would allow doctors to use chloroquine and hydroxychloroquine in people who were in the hospital with COVID-19. The agency later revoked the ruling amid concerns about the drugs' safety and how well they worked against the coronavirus.

You may still notice a shortage if you order this medicine. That's why experts are urging drugmakers to keep up with demand. And some states have new rules about who can get the drug. That may make it easier for people with RA to get it.

The safest way to avoid exposure to germs is to stay home. Instead of in-person medical visits, try telemedicine. Many rheumatologists and other health care professionals now offer virtual visits on your smartphone, tablet, or computer. It’s easy, convenient, and helps you stay healthy without risk of exposure.

Experts don’t yet know how rheumatology medications affect COVID-19, so it’s important to make decisions with your doctor. Going off your medication may trigger a flare, which may be even worse. Don’t do it on your own. Talk to your doctor to weigh the risks and benefits together.

With RA, it’s extra important to keep up with your vaccines. Talk to your doctor about getting a flu shot. Ask if you should also get pneumonia and shingles vaccines.

It’s very important to get vaccinated against COVID-19, too. Top health experts recommend that you choose a vaccine made with mRNA (like the ones from Pfizer and Moderna) rather than the J&J vaccine, which is made differently.

Once you’re fully vaccinated, keep up to date with your COVID-19 booster vaccines when you’re eligible for them. Experts prefer people get the mRNA vaccines for booster doses in most situations. But you can consider getting a Novavax or J&J booster if you had a severe reaction to either of the other vaccines or if they aren’t available where you live. The FDA says the risks of the virus remain greater than the risks of effects of the vaccine. Talk to your doctor about what is best for you. 

Always wear a high-quality face mask indoors in public places, especially when you can’t keep a safe social distance of 6 feet.

Some masks offer more protection than others:

  • Loosely woven cloth masks protect you the least.
  • Layered finely woven masks protect you more.
  • Well-fitting, disposable surgical masks and KN95 respirators protect you even more.
  • Well-fitting, NIOSH-approved respirators (like N95s) give you the most protection.

Make sure it covers both your nose and your mouth. After you touch a used mask, wash your hands. Skip the gaiters and face shields. 

If you choose to wear a reusable cloth mask, wash it after you use it. You can put it with your regular laundry and use regular laundry detergent. Choose the warmest water setting that’s safe for the type of cloth you have. Make sure you dry it completely. Put it in the dryer on the highest setting or let it air dry on a flat surface.

Gloves don’t always protect you from getting infected, and they can spread germs. The CDC recommends wearing gloves when you’re cleaning or when you’re caring for someone who’s sick, but not for everyday situations like running errands, grocery shopping, or using an ATM. It’s better to wash your hands after you go out or use a hand sanitizer with at least 60% alcohol.

Clean frequently touched surfaces often. Think doorknobs, light switches, tables, countertops, handles, phones, desks, and computer keyboards. In the bathroom, pay extra attention to sinks, faucets, and toilets. Clean dirty surfaces with detergent or soap and water. Next, disinfect surfaces with a household cleaner that’s approved by the Environmental Protection Agency (EPA). Look for the EPA registration number on your cleaner, then see if it’s on the EPA’s list of approved disinfectants.

Your home is generally the safest place to be. If you socialize only with people you live with, you probably don’t need an air purifier. But if someone in your household has COVID-19 or may have been exposed to it, you may want to try an air purifier. Put it in their room and keep the door closed to lower your risk of exposure.

COVID-19 spreads mostly from person to person through droplets that get into the air from our mouths and noses. You’re more likely to inhale the droplets indoors, where you share more air. You have less risk outside, where air is constantly moving. Choose outdoor activities when you can. Go for a walk, stroll around a park, have a picnic, or try a drive-in movie. Just be sure to keep a safe distance from others.