Coronavirus disease 2019 (COVID-19)

Corona viruses are a big family of viruses that can cause everything from colds to severe pneumonia.

Most people (about 80%) have mild symptoms similar to a cold or the seasonal flu. Fever, cough and shortness of breath can show up to 14 days after infection. Few people can develop severe pneumonia, and few become critically ill.

Some people who test positive for COVID-19 never get sick but may be able to spread the virus.

Viruses spread through the droplets expelled when a person coughs or sneezes. People can also pick up the virus when they touch a contaminated surface like a countertop, handrail or doorknob and then touch their eyes, nose or mouth.

Isopropyl alcohol, hydrogen peroxide and bleach can all effectively kill surface viruses in about a minute.

COVID- 19 in autoimmune or inflammatory arthritis patients:

· In general, people with autoimmune or inflammatory arthritis who have high disease activity seem to have an increased risk of infection due to greater immune dysregulation.

· For COVID-19 and seasonal flu- Older adults and those with pre existing health problems such as cardiovascular disease, diabetes and high blood pressure, those who have been hospitalized before with infections are most at risk. One of the main concerns for people with autoimmune diseases who contract seasonal flu or COVID-19 is secondary bacterial infection.

· Risk in patients taking immunosuppressive medications:

· As of now, we do not have enough information to say whether taking immunosuppressant drugs further increases the risk of catching COVID-19. In relation to viral illness, in general biologics, JAK-inhibitors and corticosteroids – may contribute to higher risk or severity of viral infections. Hydroxychloroquine (Plaquenil) does not increase the risk of infection and methotrexate increases risk of infection only slightly.

· It is important to call your rheumatologist if you are experiencing flu like symptoms or you have been exposed to someone who has concerning symptoms. It is not advisable that you stop or change dosage of medication without calling your doctors.

Don’t worry or panic but do take steps to protect yourself and others. Here is how:

1. Wash your hands – Scrub both sides, between your fingers, under the nails for at least 20 seconds.

2. Use hand sanitizers on the go – containing at least 60% alcohol.

3. Disinfect surfaces regularly – your cellphone, computer keyboard, remote, doorknobs and faucets. Wash eyeglasses with soap and warm water every day.

4. Cover your mouth and nose when you cough

5. Fist bumps or ‘NAMASTE’ – forget handshakes and hugs for the time being

6. Skip the mask – Standard surgical face masks won’t screen out viruses in healthy people, but if you are sick, a mask can help block droplets from sneezing or coughing so you won’t infect others.

7. Call ahead – If you have cold or flu symptoms call your rheumatologists to cancel your biologic injections or infusions.

8. Your doctor will likely tell you to treat mild symptoms as you would a cold or the flu – rest, drink liquids and stay isolated from others. If your symptoms are moderate to severe, you will likely be sent to the hospital to be monitored for complications such as pneumonia.

9. If infected, you should isolate yourself at home for at least 14 days.

You can also stay up to date with new information also at www.arthritis.org