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Autoimmune Compromised Patients and Coronavirus

Holly Kelly Ennis March 23, 2020

Coronavirus disease (COVID-19) is an infectious disease caused by a new virus. The disease causes respiratory illness (like the flu) with symptoms such as a cough, fever, and in more severe cases, difficulty breathing. You can protect yourself by washing your hands frequently, avoiding touching your face, and avoiding close contact (at least 6 feet) with people who are unwell or if you are unsure if they are carriers of the virus. Coronavirus infects by human contamination. This can happen when you are in the same room with infected people. The virus can be contagious before it exhibits any symptoms. The virus enters the body via mucous membranes of the mouth, nose and eyes. Contact infection by direct body contact, infected hands or via joint door handles and the like also occurs because the virus can survive for some days on such surfaces. Incubation time (the time between infection and symptoms) can be up to 14 days, but most often 4-6 days. If symptoms do not occur within 2 weeks of exposure, one has not been infected. 

Autoimmune diseases are diseases in which the body's immune systems attacks healthy cells. The exact cause of autoimmune disorders is unknown. One theory is that some microorganisms (such as bacteria or viruses) or drugs may trigger changes that confuse the immune system.  If you suffer from an autoimmune disease, the immune system mistakenly sees normal body parts as foreign cells. This misidentification causes it to release autoantibodies, which then attack the healthy cells. This is why patients with autoimmune diseases are at higher risk of getting infected with coronavirus and developing more serious complications.There are many types of autoimmune diseases including include systemic lupus erythematosus, Sjogren syndrome, Hashimoto thyroiditis, rheumatoid arthritis, juvenile (type 1) diabetes, polymyositis, scleroderma, Addison disease and multiple sclerosis to name a few.  Due to the nature of their compromised immune systems, persons diagnosed with autoimmune diseases are at a greater risk from the coronavirus than the general public and need to take greater precautions to protect theselves.

Unfortunately, many women who were implanted with the Essure device have been diagnosed with autoimmune diseases that must be managed for the rest of their lives.  This new virus creates additional concerns for those ladies with such underlying conditions and special care should be taken to prevent immunocompromised patients from contracting coronavirus.  We urge all of the autoimmune patients to stay home and take preventative measures including:

  • Avoid close contact with people who are sick.

  • Avoid touching your eyes, nose and mouth with unwashed hands.

  • Wash your hands often with soap and water for at least 20 seconds.

  • Use an alcohol-based hand sanitizer when not near soap and water.

  • Clean and disinfect areas you and others touch often.

  • CDC does not recommend healthy people wear facemasks for protection.

Preventive measures are especially important for people with a weakened immune system. However,acording to physicians, people who use immunosuppressive drugs and do not have symptoms of infection should continue with their regular treatment during an epidemic to prevent the aggravation of severe rheumatic disease. If signs of infection with fever and other influenza symptoms should occur, a 1-2 week treatment break with the immunosuppressive therapy may be appropriate. However, it assumes that one is not completely dependent on the treatment. Each person should seek advice from their physician for current symptoms of the viral disease. Prednisolone and other cortisone preparations should not be terminated abruptly. Research is underway to test drugs for viruses (remdesivir, favipiravir and others). In addition, it is being investigated whether hydroxychloroquine (Plaquenil) and chloroquine can be preventive and as treatment against coronavirus. (references: Wang M, 2020 ; Liu J, 2020, Colson P, 2020). The Health Care System is currently testing the use of Plaquenil against viral infection and the coronavirus.  Those taking Plaquenil should ensure prescriptions are up to date and filled to ensure its continued availablility. 

In about 80% of patients affected with coronavirus, most develop flu symptoms including sore throat, lethargy, fever and dry cough with very good prognosis. In some cases, serious organ damage and death occur. In covid-19 infection, a small percentage of those infected get severe pneumonia and lung failure that can be fatal in just under 1% percent (one in a hundred) of those infected. However, we urge all those immune-compromised patients, particularly the Essure sisters, to take special care to ensure their safety and well-being.