Managing Rheumatic Diseases in COVID-19

The outbreak of Coronavirus disease-2019 (COVID-19) infection throughout the world is a matter of global emergency. Patients with comorbidities, in their old age, and with a compromised immune system are at the highest risk of mortality. Patients with autoimmune rheumatic diseases (like rheumatoid arthritis and systemic lupus erythematosus) already have a compromised immune system which is coupled with the immunosuppressive agents they take making them more susceptible to infections. Published evidence to guide treatment decisions are lacking and doubts regarding continuation and initiation of immunosuppressants remain. Rheumatic diseases are the most common immune-mediated disorder in COVID-19 patients, and in this review, we discuss how the commonly used drugs alter the patients’ susceptibility to this infection.