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Correspondence
Correspondence to ‘Risk factors for hospital admissions related to COVID-19 in patients with autoimmune inflammatory rheumatic diseases’
  1. Hendrik Schulze-Koops1,
  2. Alla Skapenko1,
  3. Andreas Krause2,
  4. Klaus Krueger3,
  5. Hanns-Martin Lorenz4,
  6. Philipp Sewerin5,
  7. Christof Specker6,
  8. Ulf G Wagner7,
  9. Anna Voormann8,
  10. Ulf Mueller-Ladner9,
  11. Reinhard E Voll10,11
  1. 1 Division of Rheumatology and Clinical Immunology, Department of Internal Medicine IV, Ludwig Maximilians University of Munich, Munich, Germany
  2. 2 Department of Rheumatology, Clinical Immunology and Osteology, Immanuel Hospital Berlin—Wannsee Branch, Berlin, Germany
  3. 3 Praxiszentrum St Bonifatius, Muenchen, Germany
  4. 4 Division of Rheumatology, Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
  5. 5 Department and Hiller-Research-Unit fpr Rheumatology, University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
  6. 6 Klinik für Rheumatologie und Klinische Immunologie, Kliniken Essen-Mitte—KEM, Essen, Germany
  7. 7 Division of Rheumatology, Department for Endocrinology, Nephrology, Rheumatology, University Hospital Leipzig, Leipzig, Germany
  8. 8 Deutsche Gesellschaft für Rheumatologie eV, Berlin, Germany
  9. 9 Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus-Liebig-University Giessen, Giessen, Germany
  10. 10 Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center—University of Freiburg, Freiburg, Germany
  11. 11 Centre for Chronic Immunodeficiency, Faculty of Medicine, Medical Center—University of Freiburg, Freiburg, Germany
  1. Correspondence to Professor Hendrik Schulze-Koops, Division of Rheumatology and Clinical Immunology, Department of Internal Medicine IV, Ludwig-Maximilians-University of Munich, Pettenkoferstrasse 8a, 80336 Munich, Germany; hendrik.schulze-koops{at}med.uni-muenchen.de

https://doi.org/10.1136/annrheumdis-2020-218997

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    The significance of inflammatory rheumatic diseases (IRDs) and their therapies for the risk of patients with respect to SARS-CoV-2 infection and the course of COVID-19 is still not fully understood. In particular, it is not completely clear whether IRDs, their therapies or other factors in patients with IRDs pose a risk to patients and what consequences should be drawn to protect patients with IRDs. In their manuscript, Nuñez et al 1 describe that in a real-world-setting SARS-CoV-2-infected patients with IRDs often require hospitalisation. Important in their observation is that this was associated with systemic autoimmune conditions (as opposed to well-controlled chronic inflammatory arthritis) and related to risk factors known also for the non-rheumatic population, such as advanced age or comorbidities, but not with the immunomodulating, antirheumatic therapy.

    These data are reassuring, as they underline once again that well-controlled IRDs per se do not pose a risk of contracting SARS-CoV-2 nor do ongoing immunomodulating therapies pose a threat for patients with IRD.2–5 Therefore, in order to avoid reactivation of an underlying IRD and to prevent the risk of increased susceptibility to infection and a possibly necessary administration of glucocorticoids to control immunological activity, several professional societies have advocated in their recommendations for the management of patients with IRDs in times of SARS-CoV-2/COVID-19 the continuation of therapy with anti-inflammatory drugs, provided that clinical symptoms of COVID-19 do not develop.6–8 On the other hand, these guidelines also recommend strict adherence to the hygiene and distance measures to reduce the risk of exposure to the virus. In this respect, several recent comparative surveys of patients with IRDs and the non-rheumatic population have shown that patients with IRDs do not actually have a different risk of infection than the general …

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors All authors have provided the initial draft, led the discussion and corrected the text.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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