Medical Insider – Dr. Cora E. Lim
Increasing autoimmune rheumatic diseases as a consequence of the COVID-19 pandemic: A hypothesis or fact?
(Part 3)
So far, we have said that the consequences of the Coronavirus Disease 2019 (COVID-19) pandemic, caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), will have a lasting effect on the health of the global population. This disease will most likely be viewed as a plague of the 21st century.
Osteonecrosis is yet another big issue amid the pandemic and several factors have been implicated in the pathophysiology of this debilitating complication which is associated with the infection and its irrational corticosteroid therapy.
It seems plausible that the developing world, including central Asian countries, encounter an upsurge in osteonecrosis due to unjustified and widespread use of corticosteroids in COVID-19 patients in outpatient and inpatient settings.
Rheumatologists like no other specialists are familiar with severe complications of corticosteroid therapies and may take the
lead in timely diagnosing and managing patients with osteonecrosis in the aftermath of the pandemic.
Admittedly, the global upsurge of ARDs is not entirely due to the COVID-19 pandemic. A recent article series in Lancet Rheumatology has revealed a global increase in musculoskeletal disorders in the last 30 years, unrelated to the pandemic.
Moreover, recent studies have shown that the natural selection of mutations of genes responsible for innate immunity has led to resistance to infections, coming at the cost of a large number of autoimmune inflammatory diseases accumulating in human populations.
An increasing number of specialists with an interest in these diseases and continuously advancing diagnostics may also contribute to impressive statistical records of ARDs.
For instance, the number of qualified rheumatologists in Kazakhstan has doubled over the past 10 years, partly contributing to the increasing statistics of diseases in the field.
To sum up, the COVID-19 pandemic and its consequences have had a profound effect on the landscape of ARDs.
The analysis of increasing statistics of ARDs necessitates more concerted actions of specialists at national and regional levels.
The expected global increase of ARDs in the post-pandemic period may lead to the stretching of human and other resources.
A concerted action of rheumatologists, including those who member APLAR, is increasingly important to face the growing need of training of new specialists, expanding rheumatology units, and supplying drugs.
The time has come to analyze and reach a consensual statement on the consequences of the pandemic and the expected actions by rheumatologists.