There was a time when we were all very scared with the COVID-19 pandemic. This fear, this uncertainty, must have been felt even more by someone living with a long-term condition like lupus. Questions like "What will happen if I get COVID?", "Am I at increased risk with this medication?" may have been on your mind. So today, let's talk about the connection between lupus and COVID-19, very simply, in a way that you can understand.
What is the connection between lupus and COVID-19 risk?
Simply put, with lupus, you are slightly more likely to get any type of infection than someone without the condition. This is because lupus changes the way our body's defenses, the immune system , work.
Think of our immune system as an army that protects our country. The job of this army is to protect us by recognizing and attacking foreign enemies (germs, viruses). But in lupus, this army gets a little confused and they can't tell who is friend or foe. So they start attacking not only foreign enemies but also our own healthy cells. We call this an autoimmune condition.
This is because the immune system of someone with lupus is often overworked and somewhat weakened. So when a virus like COVID-19 enters the body, it may be less able to fight it off successfully. As a result, lupus patients are not only more likely to get COVID-19, but also more likely to have more severe symptoms if they do.
Additionally, many people with lupus may have other health problems that can make it more difficult to fight off an infection like COVID-19:
- Lung-related diseases (e.g. Chronic Obstructive Pulmonary Disease)
- Heart disease
- Kidney problems
- High blood pressure
- Diabetes (Diabetes Mellitus)
The medications you take for lupus and COVID-19
You may be taking immunosuppressants to manage your lupus. These medications work by suppressing the overactive immune system. This can help control flare-ups of lupus.
But the other side of this coin is that because it suppresses the immune system, the risk of infection from outside increases. But the most important thing here is that you should not stop taking this medicine without your doctor's advice . Because if you stop taking the medicine, your lupus may worsen. If you get an infection while the disease is already advanced, it is even more dangerous.
Some of the immunosuppressant drugs commonly used for lupus are listed below.
| Generic Name of the Drug | Commonly used brand names |
|---|---|
| Azathioprine | Azasan, Imuran |
| Methotrexate | Rheumatrex |
| Cyclophosphamide | Cytoxan, Neosar |
| Cyclosporine | Gengraf, Neoral, Sandimmune |
| Belimumab | Benlysta |
| Rituximab | Rituxan |
| Prednisone | (Available under many brands) |
Can lupus medication cure COVID-19?
You may remember that during the early days of the COVID pandemic, there was a lot of talk about hydroxychloroquine and chloroquine, a drug used to treat lupus. There was a belief that these drugs could cure COVID-19. This led to research being conducted around the world.
Although some early studies showed some promising results, later large-scale studies confirmed that these drugs had no significant effect on COVID-19. Some people even experienced serious side effects. Therefore, although these drugs were initially approved for emergency use, their approval was later withdrawn.
The biggest problem that arose from this discussion was that this medicine, which lupus patients used to control their disease, began to become scarce in the market. This became a big problem for lupus patients in Sri Lanka as well.
Most importantly: Never, ever, use these medications as a treatment for COVID-19 based on what you hear from someone else or see online. Always follow your doctor's instructions.
What do you do if you get sick?
If you feel unwell or develop new symptoms, such as fever, cough, or difficulty breathing, the first thing you should do is call your doctor . Most people with COVID-19 have mild symptoms. This means they can recover at home.
However, as a lupus patient, there are a few things you should be especially careful about.
- If you are taking immunosuppressant medication, you may not get a fever even if you have an infection.
- Lupus patients can sometimes experience low-grade fevers for no apparent reason.
- Fever can also be a symptom of a lupus flare.
Therefore, it is very important to talk to your doctor if you experience any symptoms. Also, there are some symptoms that, if they appear, require immediate medical advice or referral to an Emergency Department (ETU) .
| Symptom | What to Do |
|---|---|
| Common COVID-19 symptoms | |
| Fever | Call your doctor immediately for advice. Stay home and rest. |
| Dry cough | |
| Slight difficulty breathing | |
| Emergency symptoms (go to a hospital/ETU immediately) | |
| Feeling very short of breath | Immediately go to the nearest hospital Emergency Department (ETU) or call an emergency ambulance service. |
| Persistent chest pain or tightness | |
| New confusion | |
| Bluish lips or face | |
Take-Home Message
- Having lupus increases your risk of contracting any infection, including COVID-19, and the risk of the disease becoming more severe.
- Avoid stopping or changing the dosage of your lupus medication for any reason without asking your doctor.
- Follow all safety instructions (washing hands, wearing a mask, social distancing) given by doctors and health authorities very carefully.
- Avoid things that can aggravate your lupus, such as physical and mental stress and sun exposure, as much as possible.
- Talk to your doctor as soon as you notice any symptoms. Recognize emergency symptoms and act immediately.
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