Department of Rheumatology, Toronto Western Hospital, Toronto, Ontario, Canada.
Department of Rheumatology, St James' Hospital, Dublin, Ireland.
Curr Rheumatol Rep. 2021 Jan 5;23(1):5. doi: 10.1007/s11926-020-00971-y.
Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) emerged in December 2019, rapidly reaching global pandemic proportions. Coronavirus disease 2019 (COVID-19) has presented unique challenges to the rheumatology community. It is known that many individuals with rheumatic disease are at increased risk of severe disease from other infections, sparking a similar fear for COVID-19. In addition, medications routinely used in rheumatology practice are being trialled as treatments, with the potential for drug shortages for rheumatology patients.
Underlying comorbidities and active disease are associated with worse COVID-19 outcomes in patients with rheumatic disease. Tocilizumab and hydroxychloroquine have not proven to be effective treatments in the management of COVID-19. Telehealth has become an essential tool for the rheumatology community to monitor patients during the pandemic. In this article, we summarise the available COVID-19 evidence that is of relevance to the rheumatology community. We discuss the risk of contracting COVID-19 in individuals with rheumatic disease, along with presenting features and clinical outcomes. We provide an overview of the treatments for COVID-19 which have significance for rheumatology. We highlight published recommendations which can guide our management of rheumatic disease populations during this pandemic. Finally, we discuss the challenges in delivering effective care virtually and present methods and tools which could be adapted for use.
严重急性呼吸综合征相关冠状病毒 2(SARS-CoV-2)于 2019 年 12 月出现,迅速蔓延至全球范围。冠状病毒病 2019(COVID-19)给风湿病学界带来了独特的挑战。众所周知,许多患有风湿病的个体因其他感染而患重病的风险增加,这引发了对 COVID-19 的类似担忧。此外,风湿病学常规使用的药物正在作为治疗方法进行试验,这可能导致风湿病患者药物短缺。
合并症和疾病活动与风湿病患者 COVID-19 结局较差相关。托珠单抗和羟氯喹在 COVID-19 的治疗中并未被证明有效。远程医疗已成为风湿病学界在大流行期间监测患者的重要工具。在本文中,我们总结了与风湿病学相关的 COVID-19 现有证据。我们讨论了患有风湿病的个体感染 COVID-19 的风险,以及其表现特征和临床结局。我们概述了对风湿病学有意义的 COVID-19 治疗方法。我们强调了可以指导我们在大流行期间管理风湿病患者人群的已发表建议。最后,我们讨论了虚拟提供有效护理的挑战,并提出了可以适应使用的方法和工具。