COVID-19 and Lupus

What Is COVID-19?

COVID-19, or the coronavirus, was discovered as a new virus in December 2019. It was first found at an animal market in Wuhan, China. It has spread around the world, traveling from the affected country to other places in the world. The effect in Italy and the United States Of America was vast. It has affected more than a million people across the globe. The classic symptoms of COVID-19 are fever, cough, shortness of breath, headache, myalgia, sore throat, etc. Right now, several vaccines against COVID-19 have been approved and are being used.

What Is Lupus?

Lupus, or systemic lupus erythematosus (SLE), is a chronic autoimmune disease that can affect multiple organs of unknown etiology. In this disease, a person's immune system affects a person's tissues and organs. The most affected body parts of this disease are joints, kidneys, blood cells, the brain, the heart, and the lungs.

The most significant sign of lupus is a butterfly rash that appears on the face, prominently in the cheek regions of the affected individuals. SLE can be genetic, but infections can also trigger it. This is more common in women than in men. The range of symptoms in SLE ranges from mild, moderate, and severe. The most commonly presented symptoms are fatigue, fever, joint pain, stiffness, swelling, photosensitivity-mediated skin rash, Raynaud's phenomenon, shortness of breath, chest pain, headaches, confusion, and memory loss. It is more important to note that, despite having many common symptoms, people with SLE tend to present unique symptoms. Not all patients need to have the same manifestations of the disease.

What Are the Variants of Lupus?

They are:

• Adult and pediatric SLE (systemic lupus erythematosus) or lupus.

• Cutaneous Lupus - In this form of lupus, the disease is limited to the skin.

• Drug-Induced Lupus - This is a disease condition where the symptoms are presented like lupus due to the prescription of certain drugs, namely Sulphonamides, Hydralazine, Isoniazid, and Procainamide.

• Neonatal Lupus - It is a rare condition that affects the offspring of women who are affected by lupus.

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What Are the Risk Factors Associated With COVID-19?

Through proper pathophysiology has not been appropriately explained, it is said that in the presence of any respiratory condition, especially when it is chronic, the risk of getting infected with COVID-19 is high. It does not mean that comorbid respiratory conditions cause COVID-19. It means that when a person with a comorbid respiratory condition like asthma or chronic obstructive pulmonary disease (COPD) gets in contact with the virus, the risk of getting the severe form of the disease is higher. As said above, Coronavirus also has respiratory manifestations like shortness of breath. Also, it is an autoimmune disease where our immune system attacks the healthy tissues of the body. These factors make lupus a risk factor for COVID-19, but it is unclear whether lupus increases COVID-19 more than the general population. More data is needed to confirm this.

What Are the Prescribed Medications?

Hydroxychloroquine was considered a medicine that could treat COVID-19. It is well known that Hydroxychloroquine is one of the regular medications used by lupus patients. Since it became viral that Hydroxychloroquine could be used in COVID-19, people worldwide started to buy and use it. This affected the lupus patients in that Hydroxychloroquine was not readily available for them. If medicines are not taken regularly for lupus, it might lead to a flare-up of symptoms; it might also be the risk of getting in contact with the virus and developing the disease. Therefore, to prevent flare-up symptoms as well as to prevent COVID-19, lupus patients have to continue their prescribed drugs as advised by rheumatologists. Also, they should not consume more than the prescribed dose in the thought that it may prevent them from COVID-19. An overdose of the drug is highly toxic, and it might lead to severe complications. No change in medication or treatment plan should be done without consulting a rheumatologist.

What Are the Precautionary Measures?

Taking proactive steps and being serious about one's health are essential to prevent COVID-19.

• Limiting travel to crowded places is one of the necessary precautionary measures. If a lupus patient must travel to a job place, it is necessary that the person has to wear a good N-95 or surgical mask.

• Washing hands with soap and water is the second best thing a person can do. Washing with plain water is not enough to kill the virus. If the person is working at any place where frequent handwashing activity is not possible, they can carry a handy hand sanitizer everywhere they travel and sanitize frequently.

• The person should avoid touching the mouth and nose unnecessarily, especially when the hand is not clean.

• Person-to-person contact must be avoided, and social distancing of six feet or more should be maintained strictly.

• Disinfecting frequent contact surfaces like door handles, mobile phones, work tables, laptops, mouse, etc., should be done regularly. Coronavirus can live up to 72 hours on contact surfaces.

• The cover cough method should be practiced since the virus spreads through droplet infection only. It is necessary to use the mask properly, as well as proper disposal of masks is essential. Because if masks are used and left on contact surfaces, and suppose the virus is present in the mask, it might lead to infection.

• Specific prevention methods for lupus patients are to take their prescribed medicines in the appropriate doses only. Failing to take medications properly and intake of overdose can increase the risk.

• Above all, healthy food intake and sleep can help in reducing fear and anxiety in lupus patients about COVID-19. If any symptoms occur, it is essential to contact a rheumatologist and act according to the advice provided. Negligence of symptoms can lead to the progression of the disease to a more severe form.

What Should People With Lupus Do If They Think They Have COVID-19?

According to the CDC (Center for Disease Control), anyone who thinks they may have symptoms of COVID-19 should:

• Stay home when sick.

• Call their doctor or emergency room in advance of a visit and follow instructions.

• Wear a facemask when people are around and before a person enters a health care provider's office.

• As much as possible, stay in a specific "sick room" and away from other people in home. Use a separate bathroom, if available.

• Limit contact with pets and animals.

• Limit movement in the community.

• Limit visitors to caregivers.

• Cover coughs and sneezes.

• Clean hands often, as recommended.

• Avoid sharing personal household items like dishes, bedding, etc.

What Are the Things That People with Lupus Need to Know?

• As they are vulnerable to viruses and developing other diseases, they should avoid exposure to the virus.

• Follow the safety guidelines, such as using cloth face coverings, avoiding nonessential travel, washing hands, social distancing, and cleaning and disinfecting touched surfaces.

• When a person is sick or if in contact with someone with COVID-19, self-quarantine yourself and consult the health care team.

• It is important for people with lupus to switch to telehealth for routine appointments during this time. Telehealth has become a convenient and useful tool to ensure everyone's safety, particularly for people with chronic diseases.

Conclusion

Feelings of helplessness and loneliness are common among people with lupus and Coronavirus disease. So take care of the mental health and get the COVID-19 vaccination. Stay in touch with family, friends, and care providers to keep the mental health stable and to let them know if a person needs any help.

Have any doubts regarding COVID-19. Call a doctor online.