Recently, a devoted reader contacted me and asked if I could comment on the risk of COVID-19 in patients who have an autoimmune disorder. While this is not directly tied to a cancer-related topic, it is worth discussing as we navigate this virus and all of the unknowns that go along with it.
First of all, if you have an autoimmune condition, you need to know you’re at greater risk for COVID-19 complications. But do you know why, and do you know how to lower your risk? Let’s take a look at this complicated issue.
Autoimmune diseases develop when your body releases autoantibodies, that when attacking an infection are helpful, but in these disorders, they attack healthy cells as if they were foreign bacteria or viruses. Your body actually turns on itself, attacking your cells as if they are an outside invader.
Now realize, there are over 100 different autoimmune disorders, depending on which cells are being attacked. An autoimmune disorder can develop into diseases such as Sjogren’s disease, lupus, Crohn’s disease, ulcerative colitis, rheumatoid arthritis, psoriasis, multiple sclerosis, Hashimoto’s disease, Celiac disease and type 1 diabetes.
Autoimmune diseases widely differ in the health problems they cause. But they have one thing in common, an overactive immune system that is attacking normal cells of our bodies.
Remember, our immune system is vital to health, a healthy immune system protects healthy cells when a foreign invader enters the body, such as an infection caused by bacteria, fungi, parasites, viruses or in some circumstances when other toxins enter our bodies.
Your body fights these invaders with a two-pronged approach. These two approaches are called innate immunity and specific immunity. This can be difficult to understand, so here goes my attempt at a simple explanation.
Innate immunity is what we’re born with — blame your parents if yours is not in good shape, and innate immunity includes your skin and other barriers as well as certain types of white blood cells called phagocytes that respond when those barriers are breached. A phagocyte surrounds the pathogen, and just like Pac Man, takes it in and gobbles it up, basically neutralizing the invader.
Specific immunity is different, it develops over time and is adaptable to address pathogens, diseases that we do not have the innate ability to fight. That is, we develop antibodies and such to fight new disease processes as we are exposed to them or vaccinated to prevent them.
As new pathogens invade our body, the immune system develops immune fighters to respond to this new disease that we are seeing for the first time. This process involves mostly T-cells and B-cells, specific types of white blood cells we possess in our body that learn who the bad guys are and adapt to kill them.
Our body develops these cells as it learns to respond to millions of threats such as bacteria and viruses. And, like phagocytes, these T-cells and B-cells work together to kill an invader such as a virus. And a very important part of this process involves the T-cells releasing chemicals called cytokines that trigger our bodies to produce antibodies. Then an amazing thing occurs: These antibodies attach to the virus and basically turn it off, eliminating the symptoms and risk of the disease.
But cytokines do more than just bind to viruses. They also help keep the immune system in check, preventing it from overreacting and causing problems in our bodies, such as inflammation.
Unfortunately, if you have an overactive immune system, setting off your immune system can be a huge problem. If you catch a cold or the flu, your immune system goes into high gear to fight to the virus, generating too many cytokines that may ignite your immune system, and thus your autoimmune condition.
And in the case of COVID-19, the excessive number of cytokines damage tissue and can lead to a breakdown in the protective lining in the lungs and blood vessels. When the lining of blood vessels in our airways, our lungs, are weakened by this inflammation, fluid and proteins that are in our bloodstream begin to leak from blood vessels and into the tiny air sacs in the lung, filling these little sacs with fluid, and preventing oxygen from entering them and thus being absorbed into our body. The lack of oxygen causes shortness of breath, a higher risk for complications, and a more severe case of COVID-19.
So, if you have an autoimmune disease, protect yourself from COVID-19 by wearing a mask and distancing yourself from others while in public. Wash your hands frequently, and stay at home as much as possible.
It’s also a good idea to strengthen your immune system by eating a nutritious diet, exercising regularly, control your stress and get a minimum of seven to eight hours of sleep each night. But at the same time, do not sleep all day; this is not good for your body.
Because there are more than 100 autoimmune conditions, there is no way I can cover all the things you can do to help prevent complications if you are exposed to COVID-19. There is no magic treatment that covers all of them. This is why it’s important to work with your doctor, even in this time of trying to stay home.
They can help you control your autoimmune condition and maintain a strong, healthy immune system. They can also make sure you’re on the right therapies, and can work with you to develop a plan to address things like diet, exercise, stress and sleep which play such a big role in moderating your immune system.
And remember, most physicians are able to discuss your health by phone or tele-health visits, so you can remain at home and still stay in touch.
Dr. C. Joseph Bennett Jr. is a board-certified radiation oncologist. If you have any suggestions for topics, or have any questions, contact him at 522 N. Lecanto Highway, Lecanto, FL 34461, or email firstname.lastname@example.org.