Risks for Lyme disease patients during a COVID-19 pandemic. A perspective.
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. A recent study found that out of 1,590 cases in China, 1 in 4 patients had at least one co-morbidity. [1] The study offers insight into the risks for Lyme disease patients during a COVID-19 pandemic.
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.
Related Articles:
Hydroxychloroquine and azithromycin for COVID-19 may be effective
References:
- 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.
- 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.
- 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.
- 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;21(3):335-337.
Fran Goodman
07/06/2020 (11:22 am)
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)
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)
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)
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.
Kelly Niddrie
07/02/2021 (9:30 pm)
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
Dr. Daniel Cameron
07/03/2021 (6:42 am)
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.
Larisa Grib
05/07/2020 (10:47 am)
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)
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)
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)
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)
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)
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.