Updated PRES recommendations for coronavirus outbreak

Date: 18.05.2020

PReS would like to share important recommendations for patients, families and doctors in the context of the COVID-19 outbreak.

1. Be updated and follow the individual country’s Ministry of Health/National public health care body’s recommendations.

2. Ensure you meticulously follow all hygiene recommendations. Please note that the new coronavirus may remain viable for hour or days on many surfaces such as handles, doorknobs, light switches, mobile phones, computer keyboards, remotes, keys, elevator buttons, toilets, sinks, tables, hard-backed chairs, etc.

Simple measures are likely to help to preserve your health and that of your family and friends:

  • Wash your hands very regularly for at least 20 seconds using soap and water. Dry hands thoroughly afterwards.
  • Try to avoid touching your face.
  • Coughing or sneezing should be into an elbow or tissue paper and the latter should be discarded safely.
  • Use disposable tissues.
  • Wear a mask when you are ill; if there are no symptoms it is not necessary to wear a mask. The mask cannot completely prevent virus transmission, but it is a good reminder of not touching your face and serves to warn others that you may not be well.
  • Practice sensible social distancing especially from people who appear to be ill, e.g. coughing or sneezing. One meter is recommended.
  • We should greet each other without shaking hands, and avoid hugs.

3. At present with the current available scientific data showing lower disease incidence, and morbidity among children, we recommend that children with rheumatic diseases on medication, will continue all therapies as usual. Follow the individual country’s Ministry of Health/National public health care body’s recommendations regarding school activities.

Be aware that at this stage recommendations may vary from one country to the other.

With the current knowledge of today, patients receiving MTX or biologics as a monotherapy are not considered to be at increased risk.

Consider that pediatric rheumatic patients might be at higher risk for COVID-19 if they are receiving:

·         corticosteroids > 0.5 mg/kg/d

·         immunosuppressive treatment (MMF, CysA, tacrolimus, Cyclophosphamide, Rituximab...)

4. Don’t stop your medications including methotrexate (MTX) and biologics, without consulting your rheumatologist. This may cause a flare of your rheumatic disease.

5. If you are on corticosteroid therapy - consult your rheumatologist regarding possible dose adjustment.

6. Patients in isolation or quarantine (without symptoms) should continue therapy as usual.

7. In case of fever and suspicion of infectious diseases follow your national advice for access to health care and to test for Covid-19. In the meantime, withhold MTX and, if taking biologics, get in touch with your treating rheumatologist for guidance

8. In the event that you have a routine rheumatology appointment consider to ask your primary care physician, or rheumatologist if this is essential, or can be safely delayed, or if it can be performed by telephone or some other remote device. This facility may vary in availability across different health care settings.

9. For all individuals, including patients with pediatric rheumatic diseases. - avoid unnecessary traveling and crowding.

10. Wishing you good health and back to regular track soon.

See also EULAR website: https://www.eular.org/eular_guidance_for_patients_covid19_outbreak.cfm

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