Does an Autoimmune Dysfunction Have an effect on My Covid-19 Dangers?

Does an Autoimmune Disorder Affect My Covid-19 Risks?

Q. I have an autoimmune disease, a variant of rheumatoid arthritis, and recently started taking medication to suppress my immune response. Do I have an increased risk of developing Covid-19 and dying?

ONE. Autoimmune diseases like rheumatoid arthritis or lupus occur when the immune system accidentally attacks normal body tissue. Treatments that suppress the immune system to prevent damage to normal tissues can make patients more susceptible to infection. It is obvious that a person with an immune system disorder may be more likely to become infected with Covid-19 and die from the virus. However, this may not be the case.

In a study outside Italy, 1 percent of nearly 2,300 patients hospitalized with Covid-19 had autoimmune rheumatoid diseases such as rheumatoid arthritis or lupus. Most of these patients had been treated with corticosteroids or other drugs that suppress the immune system prior to admission. When compared to other patients admitted to the same hospital without autoimmune diseases, there seemed to be no overall difference in the duration of Covid-19 symptoms, length of hospital stay, or likelihood of death.

A small study from New York that was also done in patients with autoimmune rheumatoid disease with Covid-19 found a hospitalization rate similar to the general population in New York City.

In another study examining electronic health records in the United States, Covid-19 patients with another immune-mediated disease, inflammatory bowel disease, were compared with Covid-19 patients without I.B.D. The researchers found no difference in the severity or death of Covid-19 between the two groups, although in this study, patients previously treated with corticosteroids may be at greater risk of severe Covid-19 infections.

In all three studies, elderly patients were more likely to have had severe Covid-19 or die, which is true for the entire population. In two of the studies, those with concomitant conditions like high blood pressure and obesity also had a higher risk of death, as did the general population.

It is possible that patients with autoimmune diseases, and especially those receiving immunosuppressive therapy, may be particularly strict with infection prevention methods such as social distancing, wearing masks, and hand washing. Such measures could have contributed to improved results of Covid-19 infection in this group compared to the results of an immunocompromised population and thus influence the overall results of these studies. In general, however, doctors have not observed a greatly increased risk of severe Covid-19 infections or death in patients with autoimmune diseases.

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Dr. Mikkael Sekeres (@MikkaelSekeres) is the director of the Leukemia Program at the Cleveland Clinic and author of the book "When Blood Breaks: Lessons from Life for Leukemia."


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