Managing Viral Infections When You Have Rheumatic Disease, with Leonard Calabrese, DO
Leonard Calabrese, DO, emphasizes the importance of candid conversations with specialists for patients with rheumatic diseases, especially those on advanced immunosuppressive therapies.
By Lana Pine | Published on October 4, 2024
5 min read
In an interview with Leonard Calabrese, DO, professor of medicine and vice chair of the Department of Rheumatic and Immunologic Diseases at the Cleveland Clinic Lerner College of Medicine, he discusses what patients with rheumatic disease need to know about managing viral infections.
Perspective is crucial, and having open, candid discussions with the specialist managing your immunologic disease is vital. It's often unreasonable, he says, to expect primary care physicians to fully understand the complexities of your condition, especially if you're on advanced therapies like methotrexate, biologics or other targeted treatments. Therefore, it's essential to prioritize those conversations with your specialist.
Next, it’s important to assess your level of vulnerability. For many patients with rheumatic or autoimmune diseases on mild forms of immunosuppression or immunomodulation, their risk isn't significantly higher than that of the general population. However, for those with more severe conditions requiring higher levels of immunosuppression, such as patients on rituximab or high-dose steroids, the risk is notably greater. These individuals are more susceptible to viral infections and their complications.
Patients in this category should be especially diligent about staying up to date on vaccines, as recommendations for immunocompromised patients frequently change. Moreover, for those most severely immunosuppressed, Calabrese emphasizes it is crucial to have a well-defined "circle of care." This means knowing exactly who to contact if they develop serious symptoms—such as a high fever that worsens—in the context of infections like COVID-19 or severe influenza.
Unfortunately, many patients fall through the cracks when it comes to knowing who to call during a crisis. Previous research has indicated that some patients, when faced with an emergency, reach out to healthcare providers who may have only limited knowledge of their complex immunosuppressive treatments or underlying disease, such as lupus, multiple sclerosis or inflammatory bowel disease.
Calabrese’s advice to patients is simple but important:be proactive in knowing your healthcare team and who to contact when complications arise.
