The role of rheumatology in the pandemic

2 minute read

Rheumatology to the rescue! In an early conference session on covid and rheumatology, presenters discussed the role of the rheumatologist in the care of infected individuals worldwide.

TGI weekend! We’re off to an action-packed start to the ACR conference this week.

I thoroughly enjoyed the two-part session on Rheumatology Complications of Emerging Viral Infections / SARS-CoV-2”. Several engaging speakers guide the way through an overview of the covid-19 pandemic and the topics of immune dysregulation and infections.

Dr Peter Hotez started us off by addressing the issue of the anti-vaccination movement, which seems to resemble a pandemic in itself. Dr Hotez pointed out that over the years, anti-vaccine rhetoric has turned into a resistance movement against the perceived authoritarian rule of science and government. He highlighted the recycled arguments used against every new vaccine developed over the years and asks, how can the medical community better engage the public to alleviate this pervasive distrust?

Dr Jinoos Yazdany showcased the global efforts to help better understand our patient population by summarising morbidity and mortality data collected from the COVID-19 Global Rheumatology Alliance registries.

This session explored the effects of individual DMARDs and biologics on clinical outcomes, then introduced the COVID-19 Acute Respiratory Distress Syndrome (ARDS) Risk calculator. The calculator can help clinicians identify high-risk patients who should be prioritised for risk prevention strategies, such as booster vaccines and post-infection monoclonal antibodies.

Recurrent infections but the patient is not on immunosuppression? Not sure what we can contribute in this case? Dr Steven Holland introduced the concept of “phenocopies”, conditions where the presence of autoantibodies against cytokines can mimic genetic diseases leading to increased susceptibility to infections and proinflammatory states. But unlike primary immunodeficiencies, these conditions are actually responsive to further immunosuppression. Rheumatology can come to the rescue once again.

If you are like me, robust knowledge of infectious diseases and immunology has not been my strength. But in the era of covid-19, we should all tune in and learn about the role of rheumatology in this global pandemic.

Dr Bonnia Liu is a final year rheumatology trainee pursuing dual training in rheumatology and nuclear medicine at Austin Hospital in Melbourne.

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