COVID-19 and Autoimmune Drugs

If you have an autoimmune disorder, you probably take medicine to manage your condition. Some of those drugs can raise your chances of getting an infection. That might include COVID-19, the disease caused by the new coronavirus. And medicines called immunosuppressants may make you more likely to have serious complications from the virus, as can your autoimmune disorder itself.

But you shouldn’t stop taking your medicine on your own. Instead, talk to your doctor about your concerns and whether you should adjust your treatment.

You can take steps to protect yourself from COVID-19. If you do get sick, your health care provider will consider all parts of your treatment when deciding what to do.

What Do Autoimmune Drugs Do?

Autoimmune disorders happen when your immune system attacks your body’s own cells or tissues. Medications for these conditions change how your immune system works. But each drug does it in a different way. Some can slow down the entire system. Others target only certain parts.

Treatments that lower your immune response include:

  • Corticosteroids. These drugs, such as prednisone and prednisolone, affect your whole immune system.
  • Disease-modifying drugs or therapies
    • Inhibitors. These make it harder for certain immune cells to work.
    • Immunomodulators. Some are also immunosuppressants. Medicines like cyclosporine can stop cells called lymphocytes, or T cells, from working.
    • Biologics/biosimilars. These mimic certain proteins in your body to help lower inflammation. They include anti-tumor necrosis factor (anti-TNF) drugs.

What Conditions Do They Treat?

These drugs help with a number of autoimmune disorders, including:

 

Should You Keep Taking Your Medicine?

Yes. That includes IVs and shots. But it’s a good idea to check in with your doctor. They’ll let you know whether you should make any changes to your treatment.

It may be more important to control your condition than to lower your chances of an infection. If you have a flare, you could end up in the hospital. That could put you into even more contact with COVID-19 or other viruses. And many autoimmune drugs stay in your body for months. That means it wouldn’t help right away if you quit taking them.

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If you take steroids, your doctor may want to lower your dose. Or they might want you to taper off your medicine.

In some cases, your doctor may stop or delay your treatment. This is more likely to happen if you get sick or if you’ve been in close contact with someone who’s tested positive for COVID-19.

Before your doctor stops or switches up your medicine, they’ll consider several things, including:

  • Whether you have COVID-19
  • Whether there are cases of COVID-19 where you live
  • The kind of drug you’re taking
  • How serious your condition is
  • Whether you’re older than 60
  • Whether you have another health problem, like lung or heart disease
  • Certain lifestyle factors

 

How to Stay Safe

Like everyone else, you should practice good hygiene. That includes washing your hands often, for at least 20 seconds. Clean the backs of your hands, in between your fingers, and under your nails. You can use regular soap and water. If that’s not an option, you can use an alcohol-based sanitizer. But it needs to have at least 60% alcohol.

If you take an autoimmune drug, you should also:

  • Avoid any unneeded travel.
  • Keep away from crowds (social distancing).
  • Stay home as much as possible.
  • Get someone else to pick up your groceries and other supplies.
  • Avoid close contact with people. Stay at least 6 feet away.
  • Wear a face mask when you have to go out.
  • Don’t touch your eyes, nose, or mouth.
  • Get a 2- to 4-week supply of medicine, if possible.

There’s no cure or vaccine for COVID-19. But you may be less likely to get sick if you prevent other diseases. So it’s important to get vaccines for infections like the flu, pneumonia, pertussis, and shingles.

When to Call Your Doctor

If you notice any of these symptoms, call your doctor:

Note that steroids and other immunosuppressants can hide a fever.

Some people also have stomach problems with COVID-19. Let your doctor know if you have:

  • A loss of appetite
  • Nausea or throwing up
  • Diarrhea

Call your doctor or 911 right away if you have:

  • A hard time breathing
  • Constant chest pain or pressure
  • Trouble thinking clearly
  • A blue tint to your lips and face

 

WebMD Medical Reference Reviewed by Arefa Cassoobhoy, MD, MPH on July 01, 2020

Sources

SOURCES:

Michael Angarone, DO, assistant professor of infectious diseases and medical education, Northwestern University Feinberg School of Medicine.

American Autoimmune Related Diseases Association: “People with Autoimmune Disease and the COVID-19 Pandemic.”

Johns Hopkins Lupus Center: “Treating Lupus with Immunosuppressive Medications,” “What Are Common Symptoms of Autoimmune Disease?” “Coronavirus, Social Distancing and Self-Quarantine.”

Crohn’s & Colitis Foundation: “Fact Sheet: Biologics,” “Resources for IBD Healthcare Professionals: 2019 Novel Coronavirus (COVID-19).”

National Multiple Sclerosis Society: “Disease Modifying Treatment Guidelines Coronavirus (COVID-19).”

Merck Manual: “Autoimmune Disorders.”

Arthritis Foundation: “Coronavirus and Arthritis: What You Need to Know.”

National Infusion Center Association: “COVID-19: Frequently Asked Questions for Infusion Patients.”

National Psoriasis Foundation: “NPF Medical Board COVID-19 Recommendations for Patients with Psoriatic Disease.”

CDC: “Coronavirus Disease 2019 (COVID-19): Steps to Prevent Getting Sick, Symptoms,” “Coronavirus Disease 2019 (COVID-19): About Cloth Face Coverings.”

International Organization for the Study of Inflammatory Bowel Disease: “IOIBD Update on COVID-19 for Patients with Crohn’s Disease and Ulcerative Colitis.”

American College of Rheumatology: “ACR Updates: COVID-19.”

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