EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2

Abstract

The provisional EULAR recommendations address several aspects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus, and the disease caused by SARS-CoV-2, COVID-19 and are meant for patients with rheumatic and musculoskeletal diseases (RMD) and their caregivers. A task force of 20 members was convened by EULAR that met several times by videoconferencing in April 2020. The task force finally agreed on five overarching principles and 13 recommendations covering four generic themes: (1) General measures and prevention of SARS-CoV-2 infection. (2) The management of RMD when local measures of social distancing are in effect. (3) The management of COVID-19 in the context of RMD. (4) The prevention of infections other than SARS-CoV-2. EULAR considers this set of recommendations as a ‘living document’ and a starting point, which will be updated as soon as promising new developments with potential impact on the care of patients with RMD become available.

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

“…The clinical form (Appendix B) will be lled at baseline and 3-and 6-month follow-up using the REDCAp platform. 7. A total of 14 mL of blood will be collected for further lab exams, according to the protocol described at gure 3.…”

“…It is worthy emphasizing this is a complex binomial with many factors involved, such as disease activity, age, comorbidities and drugs, such as glucocorticoids (GCs), conventional synthetic, speci c target or biological disease-modifying anti-rheumatic drugs (csDMARD, stDMARD or bioDMARD, respectively) and immunosuppressants [5]. Considering a possibly poorer evolution of SARS-CoV-2 infection in patients with IMRD, a large amount of questions have been posed regarding the impact of COVID-19 in the beginning of the pandemic, including withdrawal or spacing of medications, hospitalization, need of mechanical ventilation and mortality rate [6][7][8].…”

Rheumatology practice amidst the COVID-19 pandemic: a pragmatic view

“…When feasible, extending testing to HCWs and patients exposed to viral-positive subjects would be preferable, to account for pre/asymptomatic carriers. 20…”

“…Patients with RMDs are likely to be anxious and need to feel supported by their assisting rheumatologists. As recently recognised in the European League Against Rheumatism (EULAR) provisional recommendations, 20 there is currently no data to support that patients with RMDs, including those treated with disease-modifying anti-rheumatic drugs (DMARDs), have increased susceptibility to SARS-CoV-2 or a worse prognosis if infected. 27– 29 The reported higher overall risk of patients with systemic inflammatory RMDs to some infections (including viral infections) 30– 33 cannot, at the moment, be assumed for COVID-19.…”

“…This message should be clearly conveyed to patients, who are advised to follow the same guidance as for the general population and patients without RMDs. 20 Further, it is important to liaise with family practitioners, who also play an essential role in counselling and managing RMD patients.…”