Doctor’s Note: Coronavirus and those with weakened immune systems

There are many reasons why someone may have a weaker immune system than most. How can they best protect themselves?

Doctor in El Salvador - coronavirus elderly
There are many conditions that can cause someone's immune system to become weak [Jose Cabezas/Reuters]

The term “immunocompromised” has been bandied around a great deal during this coronavirus outbreak.

It is a rather medicalised term and so it is not surprising that a lot of people with health conditions or who are on prescribed medication are feeling frightened and confused.

My patients are finding little comfort in statistics and social media posts stating: “Most people will be fine and make a full recovery.” 

People who are immunocompromised frequently look healthy and can be enjoying a full and active lifestyle. So it will come as a shock to be told that they are now classed as “high risk” of developing complications if they succumb to COVID-19 and must, therefore, adjust their lifestyles almost beyond recognition.

Being immunocompromised is defined as having a weakened or impaired immune system (through illness, drugs or malnutrition) which reduces your ability to fight infections and other diseases including COVID-19.

There are too many individual conditions that can cause your immune system to become weak to list but common ones include: diabetes, inflammatory bowel disease, blood and bone marrow cancers, HIV/AIDS, people who have had their spleen removed, sickle cell anaemia, lupus, rheumatoid arthritis, certain types of thyroid disease, chronic kidney disease, chronic lung disease, chronic heart disease and chronic liver disease.

There are also lots of drugs that are vital for the treatment of conditions like cancer, lupus, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis and psoriasis that work by suppressing your immune system.

Some of these drugs are used to treat “autoimmune conditions” which is where it is the body’s own immune system that is going into overdrive and causing the problem, so suppressing the immune system is the only way to help manage the disease. People rely on these medications to help manage their illness and for a better quality of life.

Common drugs which fall into this category include steroids, some forms of chemotherapy and radiotherapy, methotrexate, cyclosporine, tacrolimus, azathioprine, mycophenolate, infliximab and, to a certain degree, long-term use of opioids.

These drugs all work in different ways but essentially suppress the immune system because that may help treat the condition they are being taken for. However, it does put people at greater risk of infection with coronavirus.

It is important to stress that if you have been prescribed these drugs by your doctor, you must not stop taking them as they will form an important part of your treatment regime and without them, your health condition could deteriorate rapidly.

Cancer treatments should continue as planned and you should keep any hospital appointments you have until told otherwise by your doctor.

If you do fall into the immunocompromised category, you must take precautions to self-isolate or at least socially distance yourself to help minimise your risk of contracting COVID-19.

Where possible, stay at home, but, if you do need to go out, avoid crowds and public spaces and stay at least two metres (6.5 feet) away from anyone who is unwell.

As always, hygiene is key: wash your hands and clean hard surfaces at least every two hours, if not more.

Although the vast majority of people who are immunocompromised will suffer only mild to moderate symptoms of the COVID-19 infection and will make a full recovery, there is an increased risk of them becoming gravely ill.

These might include being ill with the virus for longer, shortness of breath, pneumonia and respiratory distress – a condition that means the body cannot oxygenate the blood properly, which can then lead to other organs shutting down because they are not receiving what they need to function correctly.

So, taking precautions is not only necessary, it could be lifesaving.

There is no specific treatment you can take to help boost your immune system, but adopting as healthy a lifestyle as possible will certainly help. A good night’s sleep, a balanced diet rich in fruit, vegetables and lean meats and regular exercise have all shown to improve the immune system.

On a final note, it is important to say that people who are immunocompromised are also relying on those of us who are not. People who are healthy must take some responsibility not to pass the virus on during this outbreak.

We must not be complacent about our hygiene measures and daily activities.

Even if you are not particularly at risk of developing serious symptoms, you still risk becoming a vector for the disease and passing it on to those people who are vulnerable if you do become infected.

Source: Al Jazeera