General information
Coronavirus continues to affect lives across the world. For those of us with chronic health issues, concerns about the risk of contracting the virus can be magnified. The many unknowns surrounding coronavirus only make the situation worse.
Here we share what we have learned about the coronavirus (COVID-19) and its potential impact on those with psoriasis and psoriatic arthritis.
First, for everyone, the standard preventative measures should be followed as best you, your loved ones, friends, and coworkers can. A good place to find the latest information on coronavirus prevention, symptoms, and breaking news, is https://www.who.int/
Your state (and possibly county or city) has supplemental information directly relevant to specific regulations in effect for your jurisdiction.
Certain categories of people are at increased risk from coronavirus, particularly:
- People age 65 and older;
- People who live in a nursing home or assisted living facility; and
- People of all ages who have serious chronic medical conditions, including heart disease, diabetes, severe obesity, lung disease, liver disease, and those on kidney dialysis. Note that many psoriasis patients also have one or more of these conditions.
People in these groups should follow the enhanced safety measures suggested by CDC, which can be summarized as “stay home and avoid other people.”
Those in, or who have loved ones in, nursing homes and assisted living facilities, should insist that those locations follow the strictest protocols, as a stunning 42 percent of U.S. COVID-19 deaths have occurred in nursing homes and assisted living facilities, where just 0.6% of the U.S. population lives.
Key points for patients with psoriasis or psoriatic arthritis
People who are immunocompromised are also believed to be at increased risk from coronavirus. This includes patients that treat their psoriasis and/or psoriatic arthritis with different types of medication.
There are several issues of potential concern.
First, people with psoriasis have a higher risk of infection, including respiratory infections and pneumonia, than the general population. The risk is higher for those with severe psoriasis than those with mild disease.
Second, many psoriasis medications partially inhibit the immune system, further increasing infection risk. This could theoretically make it easier to catch COVID-19. (However, just to add confusion to this fast-moving situation, some experts believe that some immune-modulating medications used in treating psoriasis and arthritis could actually be used to treat some cases of coronavirus, as part of the danger in some COVID-19 cases is caused by an excessive response of the immune system – a “cytokine storm” – that these treatments might control.)
You have heard this before but it bears repeating: each patient should speak to the medical professional who manages their psoriasis and/or psoriatic arthritis treatment, to discuss if or how the pandemic might alter their particular medical profile and current treatments. And no one should make treatment changes without first speaking to their physician.
Psoriasis patients without coronavirus symptoms and at lower risk of being exposed to the virus:
For most patients who do NOT have coronavirus or its symptoms, sticking with your current treatment plan is likely the better route, based on the information currently available as well as the havoc that a psoriasis flare could have on you and your immune system. Some felt it is a closer call for those on prednisone or other systemic (ingested) corticosteroids that would typically require a taper period to avoid a rebound flare if stopped suddenly.
Psoriasis patients with coronavirus symptoms and at higher risk of being exposed to the virus:
If you test positive for coronavirus or have symptoms of it, or if you believe you have been exposed to the virus or are living with someone who has it, call your primary care doctor right away (and be sure to mention if you are taking immune-suppressing drugs); and also contact promptly the medical professional who treats your psoriatic disease and explain your potential coronavirus exposure, so that you can discuss how to proceed.
In these situations, you and your physician should seek to alter or delay your next dose or treatments that could suppress your immune system while you are actively at risk of the coronavirus. Of course, it should be done while taking steps to prevent a flare of psoriatic disease.
COVID-19 can come on rapidly, making it impractical to confer with a dermatologist prior to seeking treatment for the virus. But in all cases, when seeking treatment for potential or confirmed COVID-19, alert the doctor, clinic, or hospital of your psoriasis treatments and seek a dermatology consult as soon as possible.
Rember, maintain at least 1 metre (3 feet) distance between yourself and others. Why? When someone coughs, sneezes, or speaks they spray small liquid droplets from their nose or mouth which may contain virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person has the disease.
