Coronavirus disease-19 and rheumatological disorders: A narrative review

The global spread of coronavirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2, which originated from Wuhan, China, is likely to have an impact on the rheumatological practices due to a dilemma in both continuing and initiating immunosuppressive medications. We revi...

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Main Authors: Arghya Chattopadhyay, Debashish Mishra, Vikas Sharma, G SRSN K Naidu, Aman Sharma
Format: Article
Language:English
Published: SAGE Publishing 2020-01-01
Series:Indian Journal of Rheumatology
Subjects:
Online Access:http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2020;volume=15;issue=2;spage=122;epage=129;aulast=Chattopadhyay
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author Arghya Chattopadhyay
Debashish Mishra
Vikas Sharma
G SRSN K Naidu
Aman Sharma
author_facet Arghya Chattopadhyay
Debashish Mishra
Vikas Sharma
G SRSN K Naidu
Aman Sharma
author_sort Arghya Chattopadhyay
collection DOAJ
description The global spread of coronavirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2, which originated from Wuhan, China, is likely to have an impact on the rheumatological practices due to a dilemma in both continuing and initiating immunosuppressive medications. We reviewed the risk stratification of patients with rheumatological disorders, the safety of various anti-rheumatological drugs, and the role of multiple drugs used by the rheumatologists in managing COVID-19. The score-based risk stratification is helpful in therapeutic decision-making such as self-isolation, continuation, or initiation of immunosuppressive therapy. Most of the immunosuppressive therapies need not be discontinued unless there is an overwhelming infection. The treatment interruption should not be made in fear, and there should be shared decision-making in consultation with the patient. The proposed role of different anti-rheumatic drugs such as hydroxychloroquine and tocilizumab in COVID-19 based on some initial uncontrolled trials and case reports will become clearer when the results of various ongoing well-planned studies become available.
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series Indian Journal of Rheumatology
spelling doaj-art-fd7ece374f834ca5b0cadd3a89e2cb262025-08-20T03:25:26ZengSAGE PublishingIndian Journal of Rheumatology0973-36980973-37012020-01-0115212212910.4103/injr.injr_73_20Coronavirus disease-19 and rheumatological disorders: A narrative reviewArghya ChattopadhyayDebashish MishraVikas SharmaG SRSN K NaiduAman SharmaThe global spread of coronavirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2, which originated from Wuhan, China, is likely to have an impact on the rheumatological practices due to a dilemma in both continuing and initiating immunosuppressive medications. We reviewed the risk stratification of patients with rheumatological disorders, the safety of various anti-rheumatological drugs, and the role of multiple drugs used by the rheumatologists in managing COVID-19. The score-based risk stratification is helpful in therapeutic decision-making such as self-isolation, continuation, or initiation of immunosuppressive therapy. Most of the immunosuppressive therapies need not be discontinued unless there is an overwhelming infection. The treatment interruption should not be made in fear, and there should be shared decision-making in consultation with the patient. The proposed role of different anti-rheumatic drugs such as hydroxychloroquine and tocilizumab in COVID-19 based on some initial uncontrolled trials and case reports will become clearer when the results of various ongoing well-planned studies become available.http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2020;volume=15;issue=2;spage=122;epage=129;aulast=Chattopadhyaycoronavirus disease-19hydroxychloroquinerheumatologysevere acute respiratory syndrome coronavirustocilizumab
spellingShingle Arghya Chattopadhyay
Debashish Mishra
Vikas Sharma
G SRSN K Naidu
Aman Sharma
Coronavirus disease-19 and rheumatological disorders: A narrative review
Indian Journal of Rheumatology
coronavirus disease-19
hydroxychloroquine
rheumatology
severe acute respiratory syndrome coronavirus
tocilizumab
title Coronavirus disease-19 and rheumatological disorders: A narrative review
title_full Coronavirus disease-19 and rheumatological disorders: A narrative review
title_fullStr Coronavirus disease-19 and rheumatological disorders: A narrative review
title_full_unstemmed Coronavirus disease-19 and rheumatological disorders: A narrative review
title_short Coronavirus disease-19 and rheumatological disorders: A narrative review
title_sort coronavirus disease 19 and rheumatological disorders a narrative review
topic coronavirus disease-19
hydroxychloroquine
rheumatology
severe acute respiratory syndrome coronavirus
tocilizumab
url http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2020;volume=15;issue=2;spage=122;epage=129;aulast=Chattopadhyay
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AT debashishmishra coronavirusdisease19andrheumatologicaldisordersanarrativereview
AT vikassharma coronavirusdisease19andrheumatologicaldisordersanarrativereview
AT gsrsnknaidu coronavirusdisease19andrheumatologicaldisordersanarrativereview
AT amansharma coronavirusdisease19andrheumatologicaldisordersanarrativereview