At the time of Covid 19 pandemic, people with lupus around the world continue to experience significant obstacles and as a result, serious negative health outcomes. As the World Lupus day is observed on May 10, the challenges faced by Lupus patients are many, including apprehension of going to doctor’s appointments due to fear of risk of Covid-19 infection.
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune condition in which the immune system attacks its own tissues, weakening the body. Lupus affects one in every thousand persons in India, out of which a majority are women. The male-to-female ratio of people affected by Lupus is estimated at 1:11. It may be life-threatening disease affecting women in the age group of 15 to 45 years. As Lupus patients are put on immune suppressing medications, they will be at higher risk of contracting infections such as coronavirus, especially in cases of old age and other comorbidities.
The global findings reveal senior-citizens category suffering from auto-immune diseases are at high risk of contracting covid-19. The prescribed treatment protocols for Lupus patients may also increase the risk of opportunistic infections or lead to complications. Hence, prevention is one of the most important tools for such patients to fight against Covid-19.
Among Lupus patients, it is important to watch out for common symptoms of infection, such as a fever, difficulty in breathing, dry cough and chest discomfort. People, who experience any form of sickness, including symptoms of common respiratory conditions, should stay home and any high-risk symptoms require urgent medical attention.
Such patients should not be scared to come to hospital if the situation warrants as the hospitals are taking adequate precautions and there is no need to panic. A person with Lupus, if tested positive for coronavirus, should not stop taking any lupus medications unless a doctor advises it. Suddenly stopping medication may lead to a flare-up of symptoms, which puts additional stress on the body.
Lupus patients who are already on steroids should not abruptly stop taking them and should discuss with their doctor about the dose. There has been a lot of discussion about hydroxychloroquine (HCQ) for treating Covid-19 and the adverse effects on the heart rhythm. Lupus patients should continue taking the HCQ as advised by their doctor.
Lupus can affect one or many organs such as skin, joints, muscles, kidneys, nerves, brain, heart and lungs.
A combination of factors like genetic, hormonal and environmental conditions leads to the disease. However, it is not a contagious disease.
In Lupus patients, antibodies (kinds of proteins) instead of protecting them from viruses, bacteria and other foreign material, attack their own tissue cells. The common symptoms are significant hair loss, fever, recurrent mouth ulcers, red rashes on the cheeks ( butterfly rash), fatigue, weight loss, joint pains and swellings.
(Dr Naresh Purohit is a Medical Expert and Advisor National Communicable Disease Control Programme. He is also Advisor to six other National Health Programmes and visiting Professor in five Medical Universities of Southern India including Thrissur based Kerala University of Health Sciences. (The views and opinion expressed in this article are those of the author)