Pope Janet E
Schulich School of Medicine & Dentistry, London, ON Canada.
Western University, London, ON Canada.
Curr Treatm Opt Rheumatol. 2020;6(2):71-74. doi: 10.1007/s40674-020-00145-y. Epub 2020 Apr 30.
The COVID-19 outbreak has resulted in uncertainty for patients with autoimmune rheumatic diseases for several reasons. They are concerned about their risk of developing COVID-19 as many are immune suppressed from their disease and/or treatment, whether they should stop their advanced therapies, if they will have a worse outcome if/when infected due to their underlying medication condition(s) and if they will have drug availability, especially with press (without much data) coverage suggesting hydroxychloroquine may be used in COVID-19 infection causing diversion of medication supply. This article discusses how the pandemic affects people with systemic autoimmune rheumatic diseases.
Preliminarily, articles seem to suggest that patients with rheumatic diseases may not have more infections from SARS-CoV-2 and similar outcomes to age and gender matched patients, but fear of rheumatic medications increasing their risk, drug shortages, and work exposure all are concerns for patients.
The long term effects of the pandemic in patients with rheumatic diseases will not be known until much later and likely include stressors flaring disease (fear, illness, job loss, social isolation), post-traumatic stress, flaring due to stopping medications, less physician visits with subsequent under-treatment, and increases in chronic concomitant fatigue, pain, fibromyalgia.
新型冠状病毒肺炎(COVID-19)疫情给自身免疫性风湿病患者带来了诸多不确定性。原因如下。他们担心自己感染COVID-19的风险,因为许多患者因疾病和/或治疗而免疫抑制;他们不确定是否应停止先进的治疗方法;不确定如果感染,由于基础用药情况,病情是否会更严重;也不确定药物供应是否充足,尤其是媒体(缺乏大量数据)报道称羟氯喹可能用于COVID-19感染,导致药物供应转向。本文讨论了这场大流行如何影响系统性自身免疫性风湿病患者。
初步来看,文章似乎表明风湿病患者感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的几率可能并不更高,且与年龄和性别匹配的患者有相似的结局,但患者仍担心风湿药物会增加其风险、药物短缺以及工作暴露等问题。
这场大流行对风湿病患者的长期影响要到很久之后才会知晓,可能包括疾病复发的应激源(恐惧、疾病、失业、社会隔离)、创伤后应激障碍、因停药导致疾病复发、看医生次数减少及后续治疗不足,以及慢性伴随性疲劳、疼痛、纤维肌痛加重。