As emergency protocols for the COVID-19 pandemic as well as associated government assistance with testing and treatment access come to an end, rheumatologists may have greater difficulty helping patients who are immunocompromised manage their immune-mediated inflammatory diseases, according to a report from Healio. Experts explained that patients who are immunocompromised and have multiple physicians may be uncertain of which specialist to contact with needs related to COVID-19 infections. Further, because the term immunosuppression incorporates a large number of varying diseases, it can create difficulties in assessing which of these patients are at a higher risk of developing severe infections and which may require more aggressive COVID-19–related care. The experts suggested that rheumatologists should instead consider several factors about their patients—such as their age, comorbidities, vaccination status, and B-cell depletion—to better determine their risks. In addition, rheumatologists were advised to remain updated on the ever-changing best practices for this patient population, including treatment with antiviral medications like nirmatrelvir/ritonavir or molnupiravir. When administered early, these novel agents have proven effective at mitigating COVID-19 infections; however, experts noted that molnupiravir has not been tested extensively in patients who are immunocompromised.
May 25, 2023