An international group of skin disease experts suggest the coronavirus disease 2019 (COVID-19) may affect rheumatologic skin diseases and vice versa. According to their paper published in Dermatologic Therapy, rheumatologic skin diseases and the medications used to treat these diseases may increase the risk for COVID-19 infection.
Because there is currently a lack of data on the impact of COVID-19 infection on connective tissue diseases, the authors suggest that documented literature of other RNA viruses that cause these diseases is the best way to identify how the virus could affect the rheumatic system.
Several viruses, including coronaviruses, are potential triggers for genetically susceptible diseases such as rheumatoid arthritis (RA). Studies have shown associations between viral infections and onset of new RA or arthritis reactivation in patients in remission. The authors indicate that COVID-19 infection may result in the same outcome.
The authors emphasize that patients with rheumatic disease are more vulnerable to COVID-19 infection because of the disease and/or the medications used to manage the disease. Polyarthritis as well as HIV, polymyositis, and fibromyalgia may also occur with the COVID-19 infection and influence outcomes.
In addition, the authors indicated that patients with COVID-19 infection who also have rheumatologic skin diseases should consult with their rheumatologist immediately if they are on disease-modifying antirheumatic drugs, biologic agents, or other immunosuppressive therapies. Patients who are not infected may continue their medication, even during the pandemic. All patients with rheumatologic diseases, however, should be extra vigilant in terms of strategies to prevent COVID-19 infection.
“From current available data, no definite association can be established between COVID-19 and rheumatological disorders,” the authors wrote, “but further studies are needed to reaffirm the same.”
Arora G, Kassir M, Jafferany M, et al. The COVID-19 outbreak and rheumatologic skin diseases [published online March 31, 2020]. Dermatol Ther. doi: 10.1111/dth.13357