1. The main rheumatology associations worldwide have urged patients of autoimmune and rheumatic disease not to discontinue their medication for fear of the coronavirus.

 

2. There is currently no specific data about rheumatic disease patients or patients receiving immunomodulatory medication. We are assessing how people with autoimmune disease respond to COVID-19. However, a compromised and suppressed immunological system is likely to make us more vulnerable to contracting the virus or becoming seriously ill.

 

3. At this time there is no pharmacological treatment that can be administered as a prophylactic measure nor are we aware of when a vaccine may become available, although clinical trials are underway. Therefore, and in the absence of data concerning the influence of this type of medication, patients taking said treatments shall continue their usual regime and interrupt therapy only if infection occurs.

 

4. Small-range trials show that chloroquine and hydroxychloroquine may help treat or protect people with serious illnesses caused by COVID, and this information is still under evaluation. This may cause this drug, used by many people with autoimmune disease, to become scarce. We shall remain vigilant so competent authorities continue to provide for patients taking these drugs by medical indication.

 

5. Considering COVID-19 is easily transmitted, and to minimize exposure to the virus by patients with rheumatic disease on biological or immunosuppressant treatment, we suggest patients be remotely evaluated (by telephone, telemedicine, etc.) in zones where a health alert has been issued and for its duration.

 

6. Rheumatic patients, whether they receive biological or immunosuppressant treatment, should adopt the general measures recommended by health authorities in each country.

 

7. Health authorities, through control centers for disease prevention and other similar institutions, have stressed the importance of extreme hand hygiene, that is, washing hands frequently with soap, at least for 20 seconds. It is also recommended to avoid contact with people who may be infected, especially those who are coughing or sneezing, although it is true that contact with people who have been at risk, even if they do not have symptoms, should be avoided. Likewise, rheumatic patients, like the general population, should avoid touching their mouth, nose and eyes. Mouth and nose should be covered with a flexed elbow or a disposable handkerchief (which is thrown away and not kept in a pocket) when coughing or sneezing; and, in case of suffering a respiratory infection, avoid close contact with other people. Likewise, according to the state of alarm decreed in each country, patients, like the rest of citizens, must remain at home, except for force majeure.

 

8. The use of protective masks should not be promoted in people who are not infected. In this sense, it should be noted that only N95 masks have been shown to be effective against contagion by other coronaviruses (SARS). The use of any other type of mask can give a false feeling of protection and may cause non-infected people to lower their guard with preventive measures to avoid contagion. However, people suspected of being infected should use masks to prevent transmission of the disease.

For more information, please consult communications provided by the health authorities of your country.

 

9. Certain medications for autoimmune diseases may help people fight the coronavirus. Small trials in China and Italy have shown that tocilizumab, which inhibits IL- 6, can help treat people with COVID pneumonia. While this is one of the dozens of drugs being investigated for use against the coronavirus, many with autoimmune disease are already taking this or another drug that produces inhibition of IL-6 signaling.

 

10. Please consult official sources, the PANLAR website or your national rheumatology associations websites, their social networks and those of the official health entities in your countries, and refrain from sharing information that does originate in reliable sources.