Lyme Disease Patients and COVID-19 Risk
During the COVID-19 pandemic, many patients with chronic illnesses wondered whether their condition might increase the risk of severe infection. Early reports suggested that the COVID-19 virus could be more severe in individuals with underlying medical conditions.
A nationwide analysis of 1,590 COVID-19 cases in China found that approximately one in four patients had at least one co-morbidity. [1]
The most common co-morbid conditions included hypertension and other cardiovascular diseases. Other conditions reported in the study included cerebrovascular disease, diabetes, hepatitis B infection, chronic obstructive pulmonary disease, chronic kidney disease, malignancy, and immunodeficiency.
Co-morbidity refers to the presence of more than one medical condition in the same individual and may influence how severely a disease affects a patient.
The potential risks for Lyme disease patients during the COVID-19 pandemic deserve discussion.
[bctt tweet=”Risks for Lyme disease patients during the COVID-19 pandemic.” username=”DrDanielCameron”]
Lyme Disease and Chronic Illness
Lyme disease may function as a co-morbid condition in some patients. Individuals with Post-Treatment Lyme Disease Syndrome (PTLDS) may continue to experience fatigue, pain, cognitive difficulties, and reduced function after standard treatment.
Some patients with persistent Lyme disease symptoms report ongoing fatigue, pain, and cognitive problems, raising questions about whether chronic illness might affect immune resilience.
Individuals with persistent Lyme disease symptoms often struggle with fatigue, cognitive problems, and reduced daily function long after the initial infection.
Rheumatoid Arthritis and COVID-19 Risk
The risks associated with COVID-19 have been widely discussed for other chronic illnesses. For example, physicians have been concerned about patients with rheumatoid arthritis, an autoimmune disease.
Favalli and colleagues noted that these patients may be at higher risk for infection due to both immune system dysfunction and the effects of medications such as corticosteroids and immunosuppressive drugs. [2]
Many rheumatoid arthritis patients are treated with disease-modifying anti-rheumatic drugs (DMARDs), which are designed to slow disease progression but can also suppress immune function.
Interestingly, none of the 1,590 COVID-19 cases reported in the Chinese study included patients with rheumatoid arthritis.
Monti and colleagues later described eight patients with chronic arthritis who developed COVID-19 while receiving treatment with DMARDs. [3] Their medications were temporarily stopped during recovery.
All eight patients received antibiotics. Five had previously been treated with hydroxychloroquine. One patient required hospitalization and was treated with antibiotics, antiviral medications, and hydroxychloroquine.
Fortunately, none of the eight patients developed severe respiratory complications or died.
Cancer and COVID-19 Risk
Patients with cancer have also been identified as a group at higher risk during the pandemic.
“Several classes of cancer treatment, including chemotherapy and immunotherapy, can suppress immune systems and make patients more susceptible to COVID-19 infection,” writes Extance. [4]
Among the 1,590 COVID-19 cases analyzed in China, 18 patients had cancer. Liang and colleagues reported that these patients had a 3.5-times higher risk of requiring mechanical ventilation, ICU admission, or death compared with patients without cancer. [5]
Clinical Perspective
For Lyme disease patients and their families, the COVID-19 pandemic created understandable concern about whether their illness might increase vulnerability to severe infection.
Fortunately, the antibiotics used to treat Lyme disease do not suppress the immune system in the same way that corticosteroids or immunosuppressive medications can.
However, some individuals with persistent Lyme symptoms may have other medical conditions that could influence their overall health during viral illness.
From a clinical perspective, many Lyme disease patients worry about immune vulnerability during viral outbreaks. At present, there is limited research specifically examining COVID-19 outcomes in Lyme disease patients, highlighting the need for further study.
Clinical Takeaway
While more research is needed to understand the relationship between Lyme disease and COVID-19 outcomes, patients with chronic illnesses should remain cautious during viral outbreaks.
Patients with Lyme disease should continue general health precautions, maintain appropriate medical care, and take steps to avoid additional tick bites.
Maintaining regular communication with healthcare providers and continuing appropriate Lyme disease treatment remain important during public health crises.
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References:
- Guan WJ, Liang WH, Zhao Y, et al. Comorbidity and its impact on 1,590 patients with COVID-19 in China: A nationwide analysis. Eur Respir J. 2020.
- Favalli EG, Ingegnoli F, De Lucia O, et al. COVID-19 infection and rheumatoid arthritis: Faraway, so close! Autoimmun Rev. 2020.
- Monti S, Balduzzi S, Delvino P, et al. Clinical course of COVID-19 in patients with chronic arthritis treated with immunosuppressive therapies. Ann Rheum Dis. 2020.
- Extance A. Covid-19 and long-term conditions: what if you have cancer, diabetes, or chronic kidney disease? BMJ. 2020;368:m1174.
- Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
Dear Dr. Cameron, Before my move to Florida i was a patient of yours. Your protocol of antibiotics where a relief to my PTLDS, then of course I had a family tragedy, and all was lost. Since the move I have started on the clinical trial drug Disulfiram. I am not under a Dr guidance at this difficult time. I did start really low dose and only changed the dosage every 2 weeks. I am now up to 250 mg 1/2 am and 1/2 pm and I am really feeling relief once again. I value your guidance and would like to hear your thoughts on this drug protocol, and welcome your guidance as well. PS could you refer a Lyme Doctor in the south Florida area? Thank you for everything, and I hope you and all your staff are staying well!
I prefer to treat for Lyme disease and co-infections first. I have had a few patients who have seen some value with disulfiram if they start out slow. I don’t have any names. You might check out Global Lyme Alliance, Lyme Disease Association, or ILADS for names.
Is COVID-19 behaving somewhat like Lyme & Co-infections in regard to immune overdrive, biofilms, or organ impairment?
Treating for these for two years, then in late February 2020, a huge set-back that was either a new bug bite or relatives visiting from NYC. The only thing that helps are the herbal antivirals and Valcyclivir. Continuing the detox and supports of course.
The immune system is affected in tick-borne infections and COVID-19. It is too soon to tell.
I’ve had a Lyme disease a few years ago, was treated for that , how is it correlated with covid19 now?
I am in contact with a fair number of Lyme disease who have COVID-19. They don’t seem to be worse. I am following.
I had Lyme in 2015. Around 2017 onward, I had symptoms of Lyme arthritis in L shoulder and L elbow (arthritis and chronic tendonosis confirmed by MRI). Over a year of constant rehab and PRP showed no improvement of my condition.
I never went on DMARDs, and just managed my symptoms w/ peroxicam (allergic to meloxicam).
I’ve now had the “covid cough” for going on 2 months, and am afraid my Lyme autoimmune situation is keeping me from getting over it. (I had mild fevers and shortness of breath that first month)
I used to live in the northeast, but now I’m in CO and the rheumatologists out here admit they have no experience w/ Lyme autoimmune.
I advise my patients with the same history to look a second time at persistent infection. I also look for other causes. Call the office if you have any questions.
I had Lyme twice previously (first time was miss diagnosed for a long time), periodically I get terrible flare ups where I just want to cut my legs off because of the severe pain , I lived in CT back then I now live in VA and had COVID in April, 2021, they say I have COVID long haulers because I still experience fatigue, headaches, SOB, palpitations but recently my legs are BAD again I can barely stand
The symptoms of COVID long-haulers and Lyme disease are similar. I encourage my patients who have been labeled as having a COVID long-hauler to include a doctor with experience treating Lyme disease in their care.
I am a 72-year-old female. When I was 65, I developed Lyme disease and was put on a three-month course of amoxicillin which seem to have cured it in that other than arthritis in my hands and feet, I am symptom-free. And other than having hypothyroidism, and taking a low dose of Armour Thyroid daily, I am quite well. I live in Boca Raton Florida, and since this past March, have barely left my home. I am an active senior I want to resume my life, especially social distancing with friends but I’m very concerned between my age and the Lyme is this is a safe thing to do. I would appreciate any reference material on the subject as well. Thank you.
I have not seen any reference material on Lyme COVID-19. I have advised my Lyme disease to be extra cautious in case there is a problem.
About 6 weeks ago I was tick bitten a second time. I’m a teacher and am getting ready to go back to school even though I’ve been sick all summer. What should I do? Should I go back to see students in person?
I would evaluate a patient presenting with the same story for Lyme disease and COVID-19 or both at the same time. I would also evaluate them for other illnesses.
My husband tested positive for Lyme and multiple co-infections (we did the test ourselves via IgeneX). We live in Canada and we are trying to get diagnosed / treated here but it’s a nightmare. He is currently NOT receiving ANY treatment. Would catching COVID-19 be a very big risk to his health?
I have been in touch with a number of my Lyme disease patients who have been infected with COVID-19. They have not been worse than individuals in their family without Lyme disease. We could use a study. I advise my patients to take extra precautions with Lyme disease and COVID-19 until we know more.
A friend had Covid and appeared to be a “long hauler,” with symptoms of fatigue months after Covid appeared. For some reason, his doctor checked him for Lyme and discovered he had a case that must have been dormant for years because he was never aware of having it. A course of antibiotics ended all of his symptoms. I’m not sure if doctors routinely check for Lyme now, but perhaps they should. On the off-chance they normally don’t;t I thought I’d post this here.
I am 12 and I got Lymes Diseases last year. Will it be worse for me if I get covid?
I have followed Lyme disease patients who are ill with COVID-19. My patients have not been worse. My colleagues have not seen that Lyme disease patients have more troubles with COVID-19. I advise my patients to extra careful to avoid COVID-19 out of an abundance of caution.
Shortly after a knee replacement, I started to get very ill. The surgeon assured me it had nothing to do with my surgery. I started to see every doctor known to man. Finally I went to a doctor who said I had Lyme disease. I have tried every treatment there was. It has been 8 years since my surgery, and have felt sick every day with to many symptoms to list.I Iive a miserable existence, and no one in my family has the slightest clue what Lyme does to you.
Dr Cameron, this may sound far fetched but here goes anyway. As many of us lymies know, we can relate to long haulers syndrome. Has the following question ever crossed your mind? Could the hundreds of thousands of long haulers be in fact victims of undiagnosed Lyme disease that was triggered by covid-19? Isn’t it known that traumatic events, mental or physical, can trigger Lyme? The symptoms are eerily similar. Surely I can’t be the only one that have these thoughts. Have any covid patients with lingering symptoms been tested for Lyme? Lyme is also a world pandemic, is it not? Your thoughts would be greatly appreciated.
I am also concerned. I am afraid Lyme disease patients will be dismissed another illness e.g. fibromyalgia and chronic fatigue. We can add COVID-19 to the list.
I got covid in Dec mild case but became fatigued and weak as time went on took J &J in April and became much more weaker and fatigued, … in September I went to a MD who practices functional medicine and spent thousands and specialized testing and I tested positive for Lyme disease.
In the case of historic LYME disease which went UNTREATED and produced some allergies, ongoing arthritis and some heart flutter – is there any information please about risks of vaccination for COVID, using either Pfizer or Oxford Astra Zeneca?
I have not seen information on the risks of the vaccine for Lyme disease patients. I have patients and readers of my blogs that have tolerated the vaccine. I also have blog readers who reported a flare-up. The cause of the flare-ups are difficult to determine as flareups happen in Lyme disease patients without the vaccine.
I have Chronic lyme (1998) & toke 1st Moderma shot. Flared up my lyme! Bedridden now. Passing die off of biofilm & spirochetes & high blood pressure. Going to take 2nd shot April 21, 2021 Hoping/ praying this might give me a better quality of life. Using Rife frequencies & oxygen ozone treatments. Figure the way covid shot effect me what do I have to loose? A this time having huge die off internal & external.
I am a long hauler since 2011. I tested positive for Covid yesterday at my doctor’s office. They do not feel that I need the antiviral. I thought that we are considered immunocompromized. Apparently the CDC does not agree. Go figure. What is your opinion?
I am understanding Lyme disease has an impaired immune system instead of how immunocompromised as the CDC defines it. You could your doctor if the antiviral is available even if you are not immunocompromised per the CDC.
I’m being treated for Lyme disease that could be two month old from the first bite , now I’ve contracted Covid again and I’m very unwell. Is this worse due to me having lymes disease ?
I have found it difficult to judge the effectiveness of Lyme treatment during COVID-19. For example, they both affect cytokines.