[COVID-19 in Routine Rheumatologic Care]

Area of Science:

• Rheumatology
• Infectious Diseases
• Immunology

Context:

• The COVID-19 pandemic caused by SARS-CoV-2 has had significant global health and societal impacts.
• Patients with inflammatory rheumatic diseases on immunosuppressive/immunomodulatory therapy (DMARD) were initially presumed at high risk for severe COVID-19.
• Diagnostic challenges exist, as PCR testing alone may not always confirm COVID-19, suggesting a role for antibody testing.

Purpose:

• To evaluate the actual risk of SARS-CoV-2 infection and severe COVID-19 in patients with inflammatory rheumatic diseases on DMARD therapy.
• To explore the utility of antibody testing for COVID-19 diagnosis in conjunction with PCR.
• To identify factors potentially influencing COVID-19 outcomes in this patient population.

Summary:

• Contrary to initial assumptions, patients with inflammatory rheumatic diseases undergoing DMARD therapy do not appear to be at significantly higher risk for severe SARS-CoV-2 infection.
• The role of antibody testing as a complementary diagnostic tool for COVID-19, especially in cases with negative PCR, is highlighted.
• The protective mechanisms, whether behavioral (hygiene, restrictions) or therapeutic (DMARDs), remain unclear and require further investigation.

Impact:

• Findings suggest a potential re-evaluation of risk stratification for rheumatic disease patients during pandemics.
• Highlights the need for continued research into COVID-19 pathogenesis, diagnosis, and management in immunocompromised populations.
• Underscores the importance of addressing vaccine tolerability and efficacy in patients with inflammatory rheumatic diseases.