Cytokine Storm Autoimmune Disease

Can I get the COVID-19 vaccine if I have an autoimmune disease?

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Is the COVID-19 vaccine right for autoimmune disease patients?
The COVID-19 vaccine is expected to roll out to members of the public in early 2021. Image courtesy of the BBC.

As the COVID-19 vaccine rolls out across the nation, many members of the public are wondering if getting vaccinated against the coronavirus is right for them. More specifically, those with autoimmune disorders, a disease class in which one’s own immune system mistakenly attacks the body’s own tissues, wonder if they are candidates for the COVID-19 vaccine.

Dr. Shafinaz Akhter, Physician at Chester County Hospital in Philadelphia, PA, states, “Our advice has always been that there is no harm to getting it. It is very unlikely that you’re going to have an adverse reaction or worsening symptoms from your underlying disease based upon receiving the vaccination.” For this reason, she says that at her hospital, they are recommending that anyone with an autoimmune disease, such as lupus, rheumatoid arthritis, or Crohn’s, get vaccinated.

Furthermore, Dr. Akhter adds that many autoimmune disease patients take immunosuppressants or other immune-modulating prescription drugs, which are medications designed to decrease immune system overactivity and the damaging inflammation that comes along with it. These medications may reduce the vaccine’s ability to stimulate your body to mount an immune response against the virus. For this reason, it’s important to speak with your healthcare provider regarding the timing of when you take your medications and when you receive the COVID-19 vaccine. Examples of such medications include methotrexate or rituximab.

Dr. Anthony Fauci, the country’s top infectious disease expert, weighed in on the subject, stating, “It is clear that if you are on immunosuppressant agents, history tells us that you are not going to have as robust a response as if you had an intact immune system that was not being compromised. But some degree of immunity is better than no degree of immunity. So, for me, it would be recommended that these people do get vaccinated.”

The CDC, for its part, has stated that those with autoimmune conditions may receive the COVID-19 vaccine, while also acknowledging that no data currently exists with regards to the safety of these vaccines for autoimmune disease patients. 

The CDC adds that it is expected that the risk of the COVID vaccine for autoimmune disease patients to be minimal, based on the vaccine’s mechanism of action. This is because none of the COVID vaccines use a live virus, nor do they include an adjuvant, which is a substance that enhances the body’s immune response to an antigen. Finally, none of the available vaccines become incorporated in your own genetic material (i.e. DNA), since they are mRNA vaccines.

As with any new medical treatment, it’s encouraged to speak with your healthcare provider before making a decision on whether or not to get the vaccine, so that they can advise you based on your specific situation. To learn more about the COVID-19 vaccines, visit the CDC website.

Are you planning to get the COVID-19 vaccine? Let us know in the comments below!

Is This Illness Related to COVID-19 Autoimmune?

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Healthcare professionals are grappling with the effects of pediatric multisystem inflammatory syndrome (MICS), a complication of COVID-19 in children

Across the world, disturbing reports are coming through detailing a new complication thought to be related to COVID-19 that is affecting children with the virus. The illness, called pediatric multisystem inflammatory syndrome, or MICS for short, causes the immune system to overreact, leading to dangerously high levels of inflammation throughout the body. It impacts the body’s major organs, including the heart, liver, and kidneys, among other parts of the body.

Juliet Daly, a 12-year old girl from Louisiana, was diagnosed with both COVID-19 and MICS after going through cardiac arrest. Thankfully, she was airlifted to a children’s hospital, where she was put on a ventilator until she could breath on her own and her heart and other organs had recovered.

Juliet Daly was diagnosed with COVID-19 and pediatric multisystem inflammatory syndrome after being admitted to the hospital. Image courtesy of CNN.

Pediatric multisystem inflammatory sundrome has been compared to Kawasaki disease, an inflammatory condition primarily found in children under age five that impacts the heart’s coronary arteries. Kawsaki disease can lead to complications like artery enlargement, aneurysms, issues with the lymph nodes, skin, and the lining of the nose, throat and mouth. Some experts hypothesize that the coronavirus could be a trigger for Kawasaki disease. A recent study done in Bergamo, Italy found that the incidence of a ‘severe, Kawasaki-like disease’ increased 30-fold after the virus broke out in the region, further supporting this theory.

Pediatric multisystem inflammatory syndrome also bears the hallmarks of a cytokine storm, a phenomenon in which the body’s immune system overreacts to the virus and mounts a harmful inflammatory response in the body.

This raises the question, is MICS autoimmune in nature? While little is known about the condition, Dr. Randall Williams, Director of the Missouri Department of Health and Senior Services, said during a recent press conference that the condition is an “autoimmune reaction“, and that “it’s basically where your body reacts to an antigen and starts attacking itself.”

The relationship between viruses and autoimmune disease has been studied in the past. For example, studies have found a link between the Epstein-Barr virus (EBV) and the pathogenesis of a number of autoimmune diseases including lupus, multiple sclerosis, rheumatoid arthritis, juvenile idiopathic arthritis, inflammatory bowel disease, type 1 diabetes, and celiac disease.

Though there isn’t a cure for MICS, it’s treated by giving patients steroid and intravenous medications commonly issued to patients with an autoimmune disease, in an effort to decrease damaging inflammation.

While the coronavirus has proven to be less common and less deadly in children than adults, two young children and a teen with COVID-19 who showed Kawasaki disease symptoms have died in the state of New York. As a result, parents are advised to take precautions and contact their pediatrician or family medicine provider if your child has a fever to determine the best next steps.

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Why Autoimmune Patients with COVID-19 Should Beware of the Cytokine Storm

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As the SARS-CoV-2 virus responsible for the COVID-19 disease continues to infect people and claim lives across the globe, scientists and medical professionals are learning more about its impact on patients.

One interesting phenomenon that’s been observed is that some coronavirus patients experience relatively mild to moderate symptoms, while others experience severe, life-threatening problems that can land them in the ER. According to Sharp Health News, the virus itself may not be entirely to blame for this, but rather, an overreaction by the body’s immune system.

When a foreign agent, such as a virus, invades your body, your immune cells secrete cytokines, which are molecules that initiate an immune response. However, in some cases, immune cells continue to secrete cytokines, even after a sufficient immune response has been mounted. This is called a ‘cytokine storm’ and the overproduction of these molecules can cause a harmful inflammatory response in the body.

Certain people are more susceptible to cytokine storms than others; for example, there is evidence that those with genetic mutations in their immune cells are more vulnerable. According to creakyjoints.org, those with autoimmune conditions often have abnormally high levels of these cytokines, which is why autoimmune patients often take immune-suppressing medications. However, a cytokine storm isn’t the same as an autoimmune disease flare, though they can be related.

As detailed by creakyjoints.org, some autoimmune patients end up with cytokine storms unrelated to COVID-19. Dr. Randy Cron, a pediatric rheumatologist and author of the book Cytokine Storm Syndrome commented, “About 10% of patients with juvenile idiopathic arthritis will experience [a cytokine storm]; in some cases, multiple times.”

With regards to COVID-19, which is respiratory in nature, a cytokine storm can gravely impact a patient. Acute lung injury (ALI) is a common consequence of a cytokine storm occurring in the lungs, and if a lung infection is severe, the inflammation will spread to the rest of the body via one’s blood circulation and cause sepsis. In some cases, the immune response to an infection can even be deadly.

That’s why it’s important to ‘calm the storm’ and prevent a cytokine storm before it even happens. One type of treatment being explored for COVID-19 is hydroxychloroquine, which is an antiviral and immunosuppressant drug used to treat malaria and autoimmune diseases like lupus, rheumatoid arthritis (RA) and Sjogren’s. Although the medication is still undergoing clinical trials, many are hopeful that this drug will serve as a treatment to halt the progression of COVID-19.

Besides pharmaceutical therapies, Sharp Health News cites curcumin, a compound found in turmeric, as beneficial for its anti-inflammatory properties. A 2015 study states that in lab experiments, researchers found that curcumin blocked the release of the cytokines that are responsible for inflammation.

All in all, it’s important for autoimmune patients to guard against the coronavirus by adhering to strict hygiene guidelines, such as hand washing thoroughly with soap and water, avoiding close contact with others, and disinfecting surfaces routinely. Remember, prevention is the best form of treatment, and can help those with autoimmune disease to avoid a damaging cytokine storm.