Are my patients with rheumatic diseases at higher risk of COVID-19?

COVID-19 infection and glucocorticoids: update from the Italian Society of Endocrinology Expert Opinion on steroid replacement in adrenal insufficiency

“…If so, one would expect patients with chronic obstructive pulmonary disease, asthma or rheumatological disorders at an increased risk of severe COVID-19 presentation. Surprisingly, these comorbidities appear under-represented in patients with severe COVID-19 [3,[10][11][12]. Although confounding factors and reporting bias could account for such findings, they suggest that GCs should not be blamed or discouraged.…”

“…Despite the above mentioned reports of a lower representation of subjects taking low-dose GC among those with a more severely symptomatic COVID-19 [3,[10][11][12], to date there is no evidence supporting a beneficial (nor a detrimental) role for corticosteroids in preventing viral infection or spread. More, considering that 60-80% of infected subjects remains completely asymptomatic [4], there is no indication to increase GC therapy in asymptomatic patients with AI.…”

ReumaCoV Brasil Registry: Brazilian Study of Patients with Immuno-mediated Chronic Inflammatory Diseases Infected by SARS-CoV-2 

“…With the evidences moving forward, some Italian, American, French and Chinese databases have started to demonstrate that the risk of bad/poor outcome is quite similar to general population and could be more related to comorbidities and aging than IMRD itself [9][10][11]. However, there are controversial data, especially regarding the mortality rates [12].…”

Possible Consequences of a Shortage of Hydroxychloroquine for Patients with Systemic Lupus Erythematosus amid the COVID-19 Pandemic

“…These statements are based on general knowledge of increased infection risk in patients with SLE, extrapolation from other viral illnesses, and expert opinion. However, adding to the confusion, there is no specific information on SLE per se or on any of the commonly used immunosuppressive drugs for SLE 3 . Even summary statements from those countries farther along the track of this pandemic broadly reference "patients with serious underlying disease" as being at high risk of poor outcomes without particulars 4,5 .…”