Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 May 1;33(3):255-261.
doi: 10.1097/BOR.0000000000000786.

COVID-19 and rheumatoid arthritis

Kristin M D'Silva  1   2   3 , Zachary S Wallace  1   2   3
Affiliations
Review

COVID-19 and rheumatoid arthritis

Kristin M D'Silva et al. Curr Opin Rheumatol. .

Abstract

Purpose of review: The coronavirus disease 2019 (COVID-19) pandemic has caused significant morbidity and mortality worldwide. Patients with rheumatoid arthritis (RA) face unique challenges during the pandemic, including concerns regarding infection risk, drug shortages, limited access to care, social isolation, and mental health. This review will examine the multifaceted impacts of the COVID-19 pandemic on patients living with RA.

Recent findings: In patients with RA, risk factors for severe COVID-19 outcomes include older age and comorbidities, similar to those in the general population. Glucocorticoids, but not other classes of disease-modifying antirheumatic drugs (DMARDs), appear to be associated with a higher risk of severe COVID-19 outcomes. RA patients have been affected by changes in access to care, telemedicine, drug shortages, anxiety, and social isolation, which may contribute to disease flares.

Summary: Glucocorticoids, but not other DMARDs, are associated with a higher risk of severe COVID-19 outcomes in RA patients. Further studies are needed to explore the impact of specific DMARDs on COVID-19 outcomes, understand the broader implications of the COVID-19 pandemic on RA disease activity, and optimize the use of telemedicine in RA management.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: KMD has no disclosures. ZSW reports research support from Bristol-Myers Squibb and Principia and consulting fees from Viela Bio and Medpace.

Figures

Figure 1.
Figure 1.
Impacts of the COVID-19 pandemic on patients living with rheumatoid arthritis. COVID-19, Coronavirus Disease 2019; RA, rheumatoid arthritis. Question mark indicates further research needed.
See this image and copyright information in PMC

References

    1. Coronavirus disease 2019 dashboard: World Health Organization; [12–28-20]. Available from: https://covid19.who.int/.

    1. Michaud K, Wipfler K, Shaw Y, Simon TA, Cornish A, England BR, et al. Experiences of patients with rheumatic diseases in the US during early days of the COVID-19 pandemic. ACR Open Rheumatol. 2020;2(6):335–43.

      * This is the first survey study of rheumatic disease patients during the COVID-19 pandemic. This article demonstrated changes in access to care, medication changes, and feelings of anxiety and loneliness among rheumatic disease patients during the first 2 weeks of the pandemic.

    1. Ye C, Cai S, Shen G, Guan H, Zhou L, Hu Y, et al. Clinical features of rheumatic patients infected with COVID-19 in Wuhan, China. Ann Rheum Dis. 2020;79:1007–13.

      * This is an early study from the first few months of the COVID-19 pandemic in Wuhan, China. This study showed COVID-19 patients with rheumatic disease had higher odds of respiratory failure versus patients without rheumatic disease.

    1. D’Silva KM, Serling-Boyd N, Wallwork R, Hsu TYT, Fu X, Gravallese EM, et al. Clinical characteristics and outcomes of patients with Coronavirus Disease 2019 (COVID-19) and rheumatic disease: A comparative cohort study from a United States “hot spot”. Ann Rheum Dis. 2020;79:1156–62.

      * This is an early study from the first two months of the COVID-19 pandemic in Boston, Massachusetts, USA. This study showed COVID-19 patients with rheumatic disease had higher odds of mechanical ventilation versus comparators without rheumatic disease matched on age, sex, and date of COVID-19 diagnosis.

    1. Williamson E, Walker AJ, Bhaskaran KJ, Bacon S, Bates C, Morton CE, et al. OpenSAFELY: factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients. Nature. 2020;584:430–36.

      ** This is the largest general population-based study to date examining risk factors for COVID-19 mortality. This study showed that patients with rheumatoid arthritis, systemic lupus erythematosus, or psoriasis had slightly higher risk of COVID-19 mortality than those without these diseases.