Six Things Rheumatologists Need to Know About COVID-19 Save

I recently had the pleasure of interviewing my friend and colleague, Dr. Cassie Calabrese, rheumatology and infectious disease expert at the Cleveland Clinic, regarding the 6 things you need to know about COVID-19 at #ACR20. 

1. Encourage your patients to get their flu shot. This is especially important this year. Flu shots may limit potential exposure to others, including additional healthcare visits. Remember that we have had reports of concomitant COVID-19 and influenza infections.    

2. Get your flu shot. The number one reason that patients change their mind regarding vaccinations is due to education from providers. Lead by example and advocate for vaccination. 

3. Remain cautiously optimistic regarding a successful SARS-CoV-2 vaccine. It's our job to educate ourselves regarding potential vaccinations in order to advocate for our patients. Lancet recently published an article that revealed that 67% of patients would take a COVID-19 vaccine if recommended to them. 

4. Continue to wear face shields and masks during patient facing exposure. This along with good hand hygiene and distancing in infusion suites will help to decrease the spread in clinics.  Cleveland Clinic continues to utilize temperature screenings and questionnaires for patients. They also have a strict visitor policy unless the patient requires assistance such as the elderly and children.   

5. We still have a lot to learn about humoral immunity as there have been a few reports of COVID-19 reinfection. Fortunately, with rare exceptions, mutations do not seem clinically significant at present. 

6. We are still searching for the immunological endotype to determine which patients do poorly with COVID-19 without obvious reasons or co-morbidities. Finding the correct endotype may be a key to developing better clinical trials. A recent study in Science magazine revealed that nearly 3.5% of patients with severe COVID-19 symptoms had a genetic mutation in interferon gene signaling, our natural anti-viral defense mechanism. An additional 10% of patients were found to have neutralizing auto-antibodies to interferon.  

Remember, this is an ever-evolving situation and staying on top of the research is important, yet daunting. Check out the Cleveland Clinic's Rheumatology and Immunology Channel on VuMedi for more pearls. Cleveland Clinic Rheumatology and Immunology Series and follow Dr. Calabrese on Twitter @CCalabreseDO