Understanding Immunocompromised Conditions: Focus on Rheumatoid Arthritis and COVID-19

Being ‘immunocompromised’ refers to having a weakened immune system, which reduces the body’s ability to fight infections and other diseases. People can become immunocompromised due to congenital disorders, acquired conditions like diabetes and HIV, autoimmune diseases, and through certain medications and treatments. Autoimmune diseases that lead to an overactive immune response include rheumatoid arthritis (RA), multiple sclerosis (MS), and inflammatory bowel disease (Crohn’s and ulcerative colitis). Generally, the more immunocompromised an individual is, the less effective vaccines may be for them.

It’s crucial for immunocompromised individuals, particularly those with RA, to not stop their medications without consulting a healthcare professional. Common medications for these conditions include Hydroxychloroquine or chloroquine (HCQ/CQ), Sulfasalazine (SSZ), methotrexate (MTX), leflunomide (LEF), various immunosuppressants (e.g., tacrolimus, cyclosporine, mycophenolate mofetil, azathioprine), biologics, and Janus kinase (JAK) inhibitors. Non-steroidal anti-inflammatory drugs are also commonly used.

For patients with autoimmune inflammatory rheumatic diseases (AIIRD) such as rheumatoid arthritis, vaccines for preventable respiratory diseases are particularly important due to the potential impact of RA on lung function. Vaccines like the flu shot and pneumonia vaccine are recommended, though live vaccines, such as the nasal flu vaccine FluMist, should be avoided by those who are immunocompromised. Pneumonia, an infection of the lungs, is often caused by pneumococcal bacteria.

Rheumatoid arthritis (RA) is an autoimmune and inflammatory disease, where the immune system mistakenly attacks healthy cells, causing inflammation and painful swelling in the affected body parts. RA predominantly targets the joints, often impacting multiple joints simultaneously, including those in the hands, wrists, and knees.

In the context of the Coronavirus pandemic, immunocompromised individuals, particularly those with RA, advocate for societal changes. These include encouraging staying home when sick, normalizing the wearing of masks, and ensuring access to paid sick leave, reducing the stigma around its use.

For more detailed information on these topics, you can refer to the following sources:
Yale Medicine
CreakyJoints
HealthyWomen
UpToDate
Arthritis Foundation
CreakyJoints
CDC