Living With a Compromised Immune System and COVID-19 – Everyday Health

As the virus named SARS-CoV-2 continues to spread to more countries, healthcare experts are issuing new strategies to contain the disease it causes, COVID-19. For young, healthy people, these measures look very similar to everyday preventive actions that help fight the spread of respiratory diseases, like avoiding touching your face, maintaining a distance from those who are sick, and covering your cough or sneeze with a tissue before throwing it away.

For people whose systems are immunocompromised, those measures will be slightly different. According to the CDC, older adults, and people who have underlying chronic medical conditions such as immunocompromising conditions may be at risk for more severe outcomes.

From preparedness to healthful hacks, heres what immunologists recommend to protect yourself or a loved one who has a vulnerable immune system during this coronavirus outbreak.

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"Immunocompromised," "immunosuppressed," and "immunodeficiency" are often used synonymously, and all refer to an altered immunocompetence, which can be classified as primary or secondary. A primary immunodeficiency is generally inherited, which means an individual is born with it. When an individual is experiencing suppression of the immune system whether from medication such as chemotherapy, or due to a disease that individual has a secondary immunodeficiency, explains Douglas Roberts, MD, assistant clinical professor of medicine at the University of California Davis Medical School.

According to Dr. Roberts, immunodeficiency has to do with the diminished function of the immune system, which can lead to an inability to fight infections. Conditions that may lead to this include:diabetes, human immunodeficiency virus (HIV), cancer, Crohns disease, inherited deficiencies of the immune system, sickle cell disease, depressed immune defenses (such as low white-blood-cell count), immune suppressing medication, and malnutrition.

The risks for patients with conditions like inflammatory arthritis are predominantly related to their immune suppressing medication, rather than the disease itself, explains Roberts, whos also medical advisor to CreakyJoints.

This, coupled with other chronic conditions ... such as diabetes, which by itself predisposes patients to infections, contributes to our concerns about the occurrence and severity of infectious diseases, he says.

Roberts advises people with immunocompromised systems to remind their healthcare providers that they are taking immune suppressing medication when theyre being evaluated for infectious symptoms.

It also depends on the medication youre on, says Mark Ballow, MD, director of the allergy and immunology training program at the University of South Florida in St. Petersburg, and medical advisor for the Immune Deficiency Foundation.

Since there isnt a lot of information on COVID-19 and the medical community doesnt have a lot of data on newer biologics either, like common TNFs inhibitors used to treat ulcerative colitis and rheumatoid arthritis, Dr. Ballow said its hard to know if those individuals are more at risk as a result of their medication.

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A major concern with the flu, and likely the new coronavirus, is that an immune system weakened by medication and also fighting a viral infection may not be able to fight off a potentially deadly bacterial infection, explains Roberts.

In fact, this is the cause of most deaths from influenza it's not the flu virus itself, but a secondary bacterial infection (often pneumonia) caused by staph or strep bacteria that leads to mortality, he says.

Ballow advises seeking advice from your primary care physician in order to get tested,because early recognition of symptoms is vital in addressing the disease.

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From the available data, individuals over 70 and those with any chance of lung disease are at a higher risk, explains Ballow. We have a lot more patients on biologics for IBD, psoriasis, and autoimmune hemo anemia (this destroys blood cells), which suppress the immune system, he notes.

The more severe or potentially life- or organ-threatening rheumatic diseases, such as lupus, systemic vasculitis, and severe forms of rheumatoid arthritis, may require stronger or higher doses of medication, Roberts explains.

These medications suppress the immune system to a greater degree, exposing the individual to greater risks due to infections, he says. Sometimes these conditions and medications may make it difficult to detect infections, since patients may not exhibit the normal symptoms of infections, such as high fevers or high white blood cell counts. Roberts explains that any unusual or unfamiliar symptom in these patients should be viewed with suspicion.

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According to Ballow, right now international travel is a concern because we don't have a vaccine. He recommends paying attention to the geographic areas where there have been confirmed cases, avoiding high-population spots, like movie houses and restaurants, and using practical, good sense treat it like any virus.

My patients seem worried about potential travel exposures, and potentially contracting an illness from close contacts and family members, especially children and grandchildren, says Roberts. He added that theyre also concerned about the safety of the flu vaccine so he reminds them its probably the best protection against the flu available to them.

If his patients decide to travel, he recommends that they choose their travel destinations wisely, and ensure that access to high-quality medical care is available at their destination.

We dont have a specific remedy because there arent specific antibodies, explains Ballow. He suggests patients with compromised immune systems maintain their replacement immunoglobulin therapy. This is a treatment to boost your antibodies when theyre low. This, combined with good diet and exercise, is the best ways to stay healthy during the outbreak.

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Living With a Compromised Immune System and COVID-19 - Everyday Health