一种具有自身免疫条件的人的冠状病毒指南

到目前为止，它很明显：新的冠状病毒没有区分。年轻人，老年人，健康个体和具有预先存在的条件的人都存在风险。如果您有自身免疫性疾病，可以理解您担心您的病情或治疗如何 - 可能会让您更容易受到Covid-19或者如果您感染者，则会努力解决症状。

Approximately 24 million Americans have some form of an autoimmune disease—a class of illnesses that encompasses 80 different conditions, ranging from lupus to multiple sclerosis to rheumatoid arthritis. Another 8 million people in the U.S. are believed to carry auto-antibodies, blood molecules that raise your chance of developing an autoimmune disease, according to the National Institute of Environmental Health Science.

当您有自身免疫性疾病时，它基本上意味着您的免疫系统发生故障，而不是保护身体免受外部疾病和感染，而是错误地开始攻击您的身体健康组织。

If you fall into this category, it’s likely that you have two very pressing questions right now: First, will your compromised immune system have a harder time fighting off COVID-19 than a healthy person—either in terms of contracting the virus or in handling the symptoms if you get it? And second, will the medications you take to for your autoimmune condition—frequently, types of immunosuppressants—make you more vulnerable to this virus?

Here’s what the experts told us.

受损的免疫系统会提高您的Covid-19风险吗？

While scientists know that people with autoimmune disorders have a greater risk of infection stemming from bacteria (think, a bout of pneumonia after the flu), little research has been done looking at how viral infections themselves affect people with autoimmune disorders. And even less is known about whether these conditions increase your risk of being hit with COVID-19, the disease that results from the infection of the SARS-CoV-2 virus.

“We don’t know, honestly,” says Eric Ruderman, M.D., a rheumatologist at Northwestern University Feinberg School of Medicine in Illinois. “We are taking an abundance of precaution, and assuming that patients may be at a somewhat higher risk.”

Other experts agree. “We advise our patients to be very vigilant, even under the best of circumstances.” says Beth Jonas, M.D., chief of the rheumatology, allergy and immunology division at the University of North Carolina School of Medicine in Chapel Hill. “Now, we’re in the worst of circumstances.”

But contrary to what you might think, while your immune system may be going haywire attacking your joints in the case of RA, or your myelin in the case of MS, that doesn’t necessarily mean you’re more susceptible to getting a viral infection or being unable to fight it off. “We don’t have data to support that,” says Dr. Jonas.

自身免疫疾病MEDS是否提高了严重的Covid-19症状的风险？

It’s logical to wonder whether the drugs you take for lupus, rheumatoid arthritis, and other autoimmune diseases could inadvertently make a case of COVID-19 worse. After all, immunosuppressants work by dampening the activity of the immune system (which is overactive in the case of these disorders). So does that mean when a virus like SARS-CoV-2 comes along, you have fewer tools with which to fight it?

“我们肯定地知道，我们向RA给予人们的所有药物都抑制了免疫系统，并在某种程度上增加了严重感染的风险，”Jonas博士说。已显示出一种称为JAK抑制剂的药物，通常用于治疗类风湿性关节炎，以增加某些病毒感染的风险。已显示出现各种自身免疫疾病的其他药物，用于增加细菌感染，如结核病和某些真菌感染的风险。

尽管如此，在Covid-19感染的情况下，拍摄通常的Meds仍然是您可以做的最好的事情。“我们非常清楚地推荐患者继续他们的药物，包括他们的生物药物，”Ruderman博士说。“一个燃烧的病人，因为他们不服用他们的药并没有真正搞得自己。”

考虑一下：你不希望你的身体的能量试图在试图应对病毒的症状的同时试图对抗耀斑。这也是必须前往医院处理爆发的最糟糕时间 - 当医疗资源延伸薄而较薄时，您的风险从一个拥挤的候诊室旅行拾取病毒。

为此，如果您通过注入需要您的药物治疗，要求您前往医疗保健设施，您可能希望咨询您的提供商有关允许您暂时留在家的替代方案。“这真的是我们现在面临的平衡行为，”乔纳斯博士说。如果您确实开发了Covid-19症状或测试肯定，请与您的医生咨询您是否应该暂时停止服用免疫抑制剂。

如果您是免疫引起的，可以安全地获得Covid-19疫苗是否安全？

In December 2020, we finally got the news we've been waiting for: two COVID-19 vaccines received FDA approval and are now being distributed nationwide. The Pfizer and Moderna vaccines are considered safe and effective for the general public, but what about immunocompromised folks? Is there anything they should be worried about?

不幸的是，专家们对疫苗在这个人口中的影响仍然很少了解。免疫表明的人不包括在临床试验中，因此在确凿的数据之前将是几个月的，可以担保此组的疫苗安全。该理论是因为mRNA疫苗不含活病毒或弱化病毒，因此它们应该比某些传统疫苗更安全。但专家们肯定不知道这一点。

目前，如果他们希望接收Covid-19疫苗，则可以选择具有自身免疫条件的人。但是你永远不能太小心，所以专家建议与你的医生交谈，以便在做出选择之前得到他们的建议。

As vaccine researchers continue to gather more information, there are still things you can do to stay healthy. Yes, the ubiquitous “wash your hands and socially distance yourself” applies. And be extra-conscious to steer clear of anything that is a potential trigger for your condition. And finally, during these anxious times, do what you can to minimize one of the biggest immune system suppressants of all: Stress. Sleep 7 to 9 hours, eat well, and exercise a little on most days. “Those are small things, but they just might help some people to stay a little healthier,” says Alison Ehrlich, M.D., a dermatologist in private practice at FoxHall Dermatology in Washington, D.C. They’re sure not going to hurt.