Covid-19: Risk Assessment

Assessing YOUR Level of Risk from Covid-19.

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There are various factors influencing your level of risk.

You need to take all five factors into consideration before deciding your risk level.  Most people with active vasculitis or who are taking any medication to control their disease should consider themselves to be High Risk or “Vulnerable”. 

1. AGE

Risk increases with age over 50:

Age-group	Increased	High	Very High	Extremely High
50-59	X
60-69		X
70-79			X
80+				X

2. Type of Vasculitis

Any Auto-immune Connective Tissue Disease – High

Individual vasculitis diseases:

	Increased	High	Very High
Relapsing polychondritis		X	X
ANCA-associated vasculitis: GPA: Granulomatosis with polyangiitis ( Wegener’s) EGPA: Eosinophilic granulomatosis with polyangiitis (Churg Strauss) MPA: Microscopic polyangiitis		X	X
Aortitis		X	X
Takayasu/Takayasu’s arteritis		X	X
Giant cell arteritis (GCA)/temporal arteritis		X	X
Behcet’s disease		X	X
Polyarteritis nodosa (PAN)		X	X
IgA Vasculitis (HSP)		X	X
Cryoglobulinaemia		X	X
IgG4 RD		X	X
Polymyalgia Rheumatica (PMR)	X

3. Increased Risk due to your vasculitis medication

	Increased	High	Very High
Prednisolone on its own up to 19mg/day	X
Prednisolone up to 10mg/day: also on other immunosuppressants	X	X
Prednisolone in combination with other immunosuppressants		X	X
Prednisolone 20mg or more per day		X	X
Methotrexate		X
Leflunomide		X
Azathioprine		X
Mycophenolate mofetil/Myfortic		X	X
Cyclophosphamide – IV or Oral		X	X
Biologics, eg Rituximab and other biosimilars		X	X

4. Increased Risk due to Co-morbidities (other conditions)

Your risk increases by at least one level, eg from High to Very High, if there is the presence of other co-morbidities, such as:-

1. interstitial lung disease/pulmonary fibrosis, pulmonary hypertension/pulmonary arterial hypertension,
2. glomerulonephritis/renal impairment (any cause)
3. neutropaenia,
4. liver disease,
5. diabetes mellitus,
6. ischaemic heart disease, other underlying lung disease (such as asthma, chronic obstructive pulmonary disease; COPD), pregnancy and older age.

For a definitive level for your individual circumstances, contact your consultant or medical team, NOT your GP.

Some patients with very active disease, eg newly diagnosed and on IV Cyclophosphamide may be at Very High risk.

5. Additional Risk Factors for Vasculitis Patients

Smoking is a very significant increased risk factor

Immune Suppression

There is no hard evidence at present to show that that immune suppressed patients are at greater risk of catching the virus.

However there is ample evidence that in those who are immune suppressed, if they do catch the virus, the course of the disease will me much more severe and dangerous

Use of immunosuppressants (conventional or biological) is probably more relevant in defining risk rather than the underlying individual disease. Many patients are on more than one of these drugs, thus increasing their overall risk

All of the drugs listed above would put an individual at an increased risk. The presence of additional risk factors would put them at a high risk or very high risk.