COVID-19 prophylaxis, diagnostics, and treatment in patients with rheumatic diseases. The Polish experts panel opinion

• Published in: Reumatologia Vol. 62; no. 1; pp. 4 - 17
• Main Authors: Kwiatkowska, Brygida, Krajewska-Włodarczyk, Magdalena, Batko, Bogdan, Maślińska, Maria, Stajszczyk, Marcin, Świerkot, Jerzy, Wiland, Piotr, Żuber, Zbigniew, Tomasiewicz, Krzysztof
• Format: Journal Article
• Language: English
• Published: Poland Termedia Publishing House 01.01.2024
• Subjects: antiviral treatment; covid-19; eases; omicron xbb.1.5; recommendations; rheumatic and musculoskeletal dis; vaccination; COVID-19; antiviral treatment; Omicron XBB.1.5; recommendations; rheumatic and musculoskeletal diseases; vaccination
• ISSN: 0034-6233; 2084-9834
• DOI: 10.5114/reum/183469

As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) evolves, infection management in vulnerable populations requires formalized guidance. Although low-virulence variants of SARS-CoV-2 remain predominant, they pose an increased risk of severe illness in adults with rheumatic and musculoskeletal diseases (RMDs). Several disease-specific (chronic long-grade inflammation, concomitant immunosuppression) and individual (advanced age, multimorbidity, pregnancy, vaccination status) factors contribute to excess risk in RMD populations. Various post-COVID-19 manifestations are also increasingly reported and appear more commonly than in the general population. At a pathogenetic level, complex interplay involving innate and acquired immune dysregulation, viral persistence, and genetic predisposition shapes a unique susceptibility profile. Moreover, incident cases of SARS-CoV-2 infection as a trigger factor for the development of autoimmune conditions have been reported. Vaccination remains a key preventive strategy, and encouraging active education and awareness will be crucial for rheumatologists in the upcoming years. In patients with RMDs, COVID-19 vaccines’ benefits outweigh the risks. Derivation of specialized diagnostic and therapeutic protocols within a comprehensive COVID-19 care plan represents an ideal scenario for healthcare system organization. Vigilance for symptoms of infection and rapid diagnosis are key for introducing antiviral treatment in patients with RMDs in a timely manner. This review provides updated guidance on optimal immunization, diagnosis, and antiviral treatment strategies.