Coronavirus (COVID-19) and the Immunocompromised



COVID-19 has taken the world over it seems, and the everyday lives of people all over the planet have been completely disrupted. But what does this mean for people who are immunocompromised? First, let’s take a look at what these terms mean.

What does it mean to be immunocompromised?

Someone who is immunocompromised has a weakened immune system that does not respond properly to invading infections or pathogens. Meaning your body cannot fight off things like the coronavirus as well as a person with a fully functioning immune system.

A person can be immunocompromised for many reasons. Some of the factors that may play into a weakened immune system are: recent surgeries, age, genetics, having a chronic illness or by taking certain medications. Immunosuppressants are one such example. Immunosuppressants play an important role in actively suppressing an overactive immune system in patients with auto-immune diseases. By dialling down the immune system, a patients disease and some of the associated symptoms are well managed or controlled. So, what kind of extra precautions should someone who is immunocompromised be taking during this pandemic? We need to first look at how this virus is spread to understand how to protect ourselves.

Visualization of COVID-19 coronavirus

How does COVID-19 spread?

COVID-19 is actually a close cousin of the common cold. It comes from a group of viruses (called coronaviruses) that cause respiratory infections. Some of these include other serious infections such as Severe Acute Respiratory Syndrome (SARS) and the Middle East Respiratory Syndrome (MERS). Anyone who is immunocompromised is at greater risk of respiratory infections than the average person.

COVID-19 is the most recently discovered member of the coronavirus family. Symptoms include cough, sore throat, fever, sneezing and shortness of breath. The World Health Organizing (WHO) is continuing to closely asses new research on COVID-19 and how the virus is spread. So far, we have learned through research that COVID-19 is mainly spread through contact with droplets that have been expelled from the lungs of an affected person. Usually by coughing or sneezing.

You can contract the virus if:

  • You inhale any small amount of droplets containing the virus when an infected person coughs or sneezes near you, sending the virus into the air.
  • You touch a surface that the virus is currently living on (transmitted from a cough or sneeze of another person, then touch your nose, eyes or face. The virus then enters the body through these openings and makes its way to your lungs. The virus can live anywhere from hours to days without a host, depending on what the surface is made of (Harvard Health).

What extra measures should the immunocompromised and their care givers take during this crisis?

If you are suffering from a chronic illness and/or are on any kind of immunosuppressant, your immune system is compromised, and you are high-risk. This means if you are to contract the virus, there is higher risk that your symptoms will be more severe. In the worst cases, COVID-19 infections can result in death, so it is paramount that you follow the measures outlined below carefully.

If you are a caregiver of someone who is immunocompromised, it is equally as important that you remain vigilant, to avoid spreading the virus to the person in your care.

To reduce the spread of COVID-19, we recommend the following steps:

  • First and foremost, if you are on a medication that suppresses your immune system, DO NOT STOP TAKING YOUR MEDICATION. We know that with everything going on, this might be your first reaction, but this is absolutely not an option. Stopping any sort of treatment plan without direct guidance from your healthcare provider is dangerous and could land you in the hospital, which is the absolute last place you want to be right now. Please, continue to take your medication and implement extra precautions in your day to day life until the threat has passed.
  • Handwashing: Now is the time to learn how to wash your hands like a surgeon! You need to be washing your hands regularly. If you leave the house (though we don’t recommend it), wash your hands, if you sneeze, wash your hands, if your cat sneezes, WASH YOUR HANDS! You should also be sanitizing things you touch on a regular basis…when was the last time you disinfected you phone? Give it a scrub! This also goes for car keys, remote controls, your keyboards, door knobs, delivered packages (yes even carboard ones).
  • Cover your mouth and nose: Make sure never to use your hands to cover your face when you cough or sneeze, always use the crook of your arm. It is important to maintain 1.5 meter distance from anyone, especially if they cough or sneeze.
  • Stay home: If you are immunocompromised, stay home. Physical distancing is really the most effective way to ensure your safety. Rely on friends and family to help you with things like groceries. Have them pick up things you need when they are out for themselves and leave them at your door (don’t forget to wipe them down before putting them away). Only open the door to collect your goods once they have gone. If you are able to work from home, then hunker in. The more you stay inside, the less likely it is that you will contract the virus.
  • Avoid anti-inflammatories such as ibuprofen: Though this is still controversial, the WHO has recommended against using these types of medications, as there has been some evidence that using Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) may increase complications in cases of COVID-19.

Should you still be going to your infusion centre?

If you receive your medication by IV infusion, yes, but with a few exceptions. If you are not feeling well or showing symptoms, please reschedule your appointment. For the time being, infusion centers are no longer allowing visitors to enter the clinic with patients. For a run-down of the types of protocols infusion centers have in place to ensure the safety of their patients who rely on them, please click here.

Once again, if you are on a biologic, biosimilar, immunosuppressant, steroid or any other medications that are in place to help you manage your chronic disorder, it is IMPERATIVE that you continue to take your medication. Failure to do so could result in hospitalization and put you even more at risk.

What to do if you start to show symptoms:

If you begin to show persistent symptoms, self-isolate immediately. Do not go to emergency, do not make a face to face appointment with a health care professional. Call your doctor to let them know that you are now showing symptoms of COVID-19 and suspect you have been infected. Make sure to also let your public health authority know and follow your province’s guidelines closely. Additional information on your province’s guidelines can be found here.

If it is an emergency, make a call to 911 and explain that you are an immunocompromised patient that is now showing multiple COVID-19 symptoms. They will assist you further.

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