Dear CRA Members,

The situation with COVID-19 is changing rapidly and there is still a paucity of evidence surrounding this emerging condition. The CRA, in addition to endorsing the ACR statement on this subject, would like to direct your attention to the EULAR and PReS statements (links below).

We have provided a few important points from these statements to help guide you through this uncertainty. We will continue to monitor the situation and provide updates as new evidence emerges or if expert consensus changes. It is also important that you continue to familiarize yourself with your own local and provincial recommendations.

Besides social distancing and hand hygiene recommendations:

  1. Patients with rheumatic diseases should continue their medications.
  2. Patients with rheumatic diseases in isolation or in quarantine (without infectious symptoms) should continue their medications.
  3. In patients with rheumatic diseases on corticosteroids, these should NOT be stopped and may require adjustment in the face of an infection.
  4. If the immunocompromised rheumatic disease patient should develop fever, cough, or shortness of breath, they should seek medical attention and advise them to mention that they are immunocompromised.It is understood that physicians have their own threshold for the interruption of therapy during an infection balancing the risk of disease flare and serious infection in individual patients. Physicians should follow their own practice and guide their patients appropriately.In general, in the event of an infection, it is prudent to consider stopping temporarily both synthetic DMARDs and biologic therapies. These can then be resumed when the treating physician judges that the infection is sufficiently resolved.
  5. Advise patients to get their vaccinations updated including seasonal influenza, pneumococcal and pertussis vaccines. These vaccines won’t prevent COVID-19 but could lessen secondary infection and will prevent illnesses that could resemble it.

On behalf of the CRA Therapeutics Committee,

Rosie Scuccimarri, MD FRCPC
Chair, CRA Therapeutics Committee

ACR message about COVID-19
EULAR Guidance for patients COVID-19 outbreak
PReS recommendations for coronavirus outbreak