The Impact of The Covid-19 Pandemic on Rheumatology Practices

By :
    Estefanía Fajardo
    Periodista científica de Global Rheumatology by PANLAR.

13 August, 2021
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An analysis around immunosuppressed patients, treatments, and the course of covid-19 in patients with rheumatologic diseases will be presented at PANLAR 2021.





EF: Hello everyone and welcome to a new Global Rheumatology videoblog where we will be doing a series of interviews of what will be the PANLAR Congress 2021. We are joined by Dr. Cristiana Sieiro. Doctor, welcome.


CS: Thank you very much. 


EF: Doctor, tell us, what is this presentation that you have in PANLAR 2021?


CS: Well, I'm going to present our work on the patients that we see on our consults, and a little bit about the impact that the covid pandemic had on the Rheumatology consult. 


At the beginning there was a lot of talk about whether immunosuppressed patients had a risk of having more complications or a slightly more severe course of a covid disease. So, our objective was to try to look at patients who were on biologic therapy and had an added risk because they were taking this type of medication and, well, it has been curious because we have seen that there has been a lot of talk about the cytokine storm and that rheumatology treatments are very useful in covid. And what we have seen is that there are treatments that can even protect patients from these complications and from the cytokine storm that we see in the covid disease. 


EF: What are those findings that were presented and with how many people was this analysis done? 


CS: Well, we collected the patients that we had on our consults, which were 820 patients, and many of the patients who had had a positive PCR or a positive antigen test, we analyzed those who were on biologic treatment and we saw that patients who had had covid and who had been admitted for covid, who had had a slightly more severe course, were taking treatment with rituximab, which is a CD20 inhibitor, and treatments such as interleukin 6 inhibitors, such as tocilizumab and sarilumab, which could, in some way, protect these patients. In other words, these patients had a significant protective value.


EF: Are you going to continue to do an a posteriori study on this issue, or are you still in the process?


CS: We did several studies of our patients here at Leon, because the truth is that we had a lot of people admitted for covid in our hospital. I have to say that we did not have many patients with rheumatic diseases admitted, and the ones we did have admitted, well, mortality has not been as high as we expected because at the beginning we were a little bit afraid. We are talking about immunosuppressed patients and the usual thing is that, of course, with a pandemic of this dimension, we would think that there could be an increase in mortality, but what we did is that we continued to collect these patients. 


And aside from that, what we are now doing is to look at the response they are having to vaccination, because that is also a very fashionable topic. If patients who are on biological treatments and make the response they should make both at the level of antibodies and at the level of cellular response, these are drugs that, well, it is already known that they can often reduce the effectiveness of vaccination, it has been seen with the flu and pneumococcal vaccines that yes, they can reduce effectiveness, and it is curious because as rheumatologists at the beginning of the pandemic we did not know very well how to proceed, our patients were very afraid, they asked us if they had to continue with biological medication and there were no clear guidelines either. I think that here in Spain at the beginning there was talk of continuing with biologic therapy, then the ACR guidelines came out and they said that patients who were being treated with rituximab had to interrupt those treatments. So, it is curious because, of course, we are talking about patients who are undergoing treatment and who may be at risk both of developing the disease and, if they are vaccinated, of not developing the protection they need to develop. 


EF: Doctor, and what is the invitation to all those who are watching this interview to enter and learn about all these research results and also to enter the PANLAR 2021 scientific program?


CS: From Spain, from León, I invite you to be present and to participate. It seems to me from the program that it is going to be a congress with a very high level, and we are going to talk about very interesting things. I think it will be of great interest both for people who like Rheumatology and for people from other specialties, so I invite you to participate. 


We are going to talk a lot about covid, which is very fashionable now, but I think rheumatology is a very interesting specialty and I am sure you will be delighted to participate. Last year I participated as an assistant, so this year I am delighted to have the opportunity to be present and to talk about some of the work we have done during this year.


EF: Thank you very much for this space for Global Rheumatology.


CS: Thank you.

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