Perspective: Risks for Lyme disease patients during a COVID-19 pandemic

woman with COVID-19 and Lyme disease treated by doctor

Hundreds of thousands of people contract Lyme disease every year. Some of them remain chronically ill. What are the risks for Lyme disease patients during a COVID-19 pandemic?

There are reports that the COVID-19 virus can be more severe in individuals with a co-morbidity. In fact, a recent study found that out of 1,590 cases in China, 1 in 4 patients had at least one co-morbidity. [1]

The most common co-morbidity was hypertension and other cardiovascular diseases. There were a few cases of cerebrovascular diseases, diabetes, hepatitis B infections, chronic obstructive pulmonary disease, chronic kidney diseases, malignancy, and immunodeficiency.

Co-morbidity, which refers to the presence of more than one disorder in the same person, can impact the outcome of a disease.

Lyme disease could be considered a co-morbid condition. Post-Treatment Lyme Disease Syndrome (PTLDS) is a complication of Lyme disease, whereby patients continue to suffer from pain, fatigue, cognitive impairment, and poor function. These patients often have weakened immune systems.

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The risks for Lyme disease patients during the COVID-19 pandemic needs to be discussed.

Rheumatoid arthritis

Meanwhile, the risks to patients with other conditions, including Rheumatoid arthritis, an autoimmune disease, have been discussed. Doctors have been concerned with the risk of infection in these patients “because of an overall impairment of immune system typical of autoimmune diseases combined with the iatrogenic effect generated by corticosteroids and immunosuppressive drugs,” Favalli writes in the article “COVID-19 infection and rheumatoid arthritis: Faraway, so close!” [2]

Disease-modifying anti-rheumatic drugs (DMARDs) are used in rheumatoid arthritis patients to slow down disease progression.

(None of the 1,590 cases of COVID-19 cases in China had rheumatoid arthritis.)

Monti and colleagues described 8 patients with Lyme arthritis who developed COVID-19. [3] Although they were receiving treatment with DMARDs, the medications were temporarily stopped while they recovered from the COVID-19 virus.

All of the 8 patients were treated with antibiotics. Five of them were on previous treatment with hydroxychloroquine. One was admitted and treated with antibiotics, antiviral medications, and hydroxychloroquine.

Fortunately, none of the 8 patients developed severe respiratory complications or died.

Cancer

The risk for cancer patients during a COVID-19 pandemic has also been discussed. “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]

Out of the 1,590 cases of COVID-19 studied in China, 18 patients had cancer. “Early published reports from China on the outcomes of patients with cancer infected with COVID-19 indicated a 3.5 times higher risk of needing mechanical ventilation or ICU admission or dying compared with patients without cancer,” writes Liang and colleagues. [5]

Lyme disease

It’s been stressful for Lyme disease patients and their families until we know more about their risks of COVID-19.

Fortunately, the antibiotics used to treat Lyme disease do not have an iatrogenic effect, as seen with corticosteroids and immunosuppressive drugs.

For now, it is important to continue universal precaution, to eat right, and avoid stress. Be careful to avoid another tick bite. And make sure you continue to receive treatment for your Lyme disease.

 

 

References:
  1. Guan WJ, Liang WH, Zhao Y, et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis. Eur Respir J. 2020.
  2. Favalli EG, Ingegnoli F, De Lucia O, Cincinelli G, Cimaz R, Caporali R. COVID-19 infection and rheumatoid arthritis: Faraway, so close! Autoimmun Rev. 2020:102523.
  3. Monti S, Balduzzi S, Delvino P, Bellis E, Quadrelli VS, Montecucco C. Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies. Ann Rheum Dis. 2020.
  4. Extance A. Covid-19 and long term conditions: what if you have cancer, diabetes, or chronic kidney disease? BMJ. 2020;368:m1174.
  5. Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335-337.
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19 Replies to "Perspective: Risks for Lyme disease patients during a COVID-19 pandemic"

  • Tricia Bown
    11/22/2020 (11:04 pm)
    Reply

    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.

    • Dr. Daniel Cameron
      11/23/2020 (7:57 am)
      Reply

      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.

  • Cleve
    11/20/2020 (4:18 pm)
    Reply

    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.

  • Emily
    09/28/2020 (8:24 am)
    Reply

    I am 12 and I got Lymes Diseases last year. Will it be worse for me if I get covid?

    • Dr. Daniel Cameron
      09/28/2020 (1:45 pm)
      Reply

      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.

  • Valencia
    07/27/2020 (10:04 pm)
    Reply

    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?

    • Dr. Daniel Cameron
      07/28/2020 (8:26 am)
      Reply

      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.

  • Leah Olson
    07/22/2020 (8:46 am)
    Reply

    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?

    • Dr. Daniel Cameron
      07/22/2020 (7:15 pm)
      Reply

      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.

  • Fran Goodman
    07/06/2020 (11:22 am)
    Reply

    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.

    • Dr. Daniel Cameron
      07/06/2020 (1:27 pm)
      Reply

      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.

  • Barry J
    05/08/2020 (8:52 pm)
    Reply

    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.

    • Dr. Daniel Cameron
      05/09/2020 (7:43 am)
      Reply

      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.

  • Larisa Grib
    05/07/2020 (10:47 am)
    Reply

    I’ve had a Lyme disease a few years ago, was treated for that , how is it correlated with covid19 now?

    • Dr. Daniel Cameron
      05/07/2020 (1:42 pm)
      Reply

      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.

  • Ellen
    04/12/2020 (9:44 am)
    Reply

    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.

    • Dr. Daniel Cameron
      04/12/2020 (11:26 am)
      Reply

      The immune system is affected in tick-borne infections and COVID-19. It is too soon to tell.

  • Dawn Johnson
    04/12/2020 (6:30 am)
    Reply

    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!

    • Dr. Daniel Cameron
      04/12/2020 (9:06 am)
      Reply

      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.


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