woman with COVID-19 and Lyme disease treated by doctor

Risks for Lyme disease patients during a COVID-19 pandemic. A perspective.

Apr 11, 2020

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There are reports that the COVID-19 virus can be more severe in individuals with a co-morbidity. A recent study found that out of 1,590 cases in China, 1 in 4 patients had at least one co-morbidity. [1] The study offers insight into the risks for Lyme disease patients during a COVID-19 pandemic.

The most common co-morbidity was hypertension and other cardiovascular diseases. There were a few cases of cerebrovascular diseases, diabetes, hepatitis B infections, chronic obstructive pulmonary disease, chronic kidney diseases, malignancy, and immunodeficiency.

Co-morbidity, which refers to the presence of more than one disorder in the same person, can impact the outcome of a disease.

Lyme disease could be considered a co-morbid condition. Post-Treatment Lyme Disease Syndrome (PTLDS) is a complication of Lyme disease, whereby patients continue to suffer from pain, fatigue, cognitive impairment, and poor function. These patients often have weakened immune systems.

[bctt tweet=”Risks for Lyme disease patients during a COVID-19 pandemic.” username=”DrDanielCameron”]

The risks for Lyme disease patients during the COVID-19 pandemic needs to be discussed.

Rheumatoid arthritis

Meanwhile, the risks to patients with other conditions, including Rheumatoid arthritis, an autoimmune disease, have been discussed. Doctors have been concerned with the risk of infection in these patients “because of an overall impairment of immune system typical of autoimmune diseases combined with the iatrogenic effect generated by corticosteroids and immunosuppressive drugs,” Favalli writes in the article “COVID-19 infection and rheumatoid arthritis: Faraway, so close!” [2]

Disease-modifying anti-rheumatic drugs (DMARDs) are used in rheumatoid arthritis patients to slow down disease progression.

(None of the 1,590 cases of COVID-19 cases in China had rheumatoid arthritis.)

Monti and colleagues described 8 patients with Lyme arthritis who developed COVID-19. [3] Although they were receiving treatment with DMARDs, the medications were temporarily stopped while they recovered from the COVID-19 virus.

All of the 8 patients were treated with antibiotics. Five of them were on previous treatment with hydroxychloroquine. One was admitted and treated with antibiotics, antiviral medications, and hydroxychloroquine.

Fortunately, none of the 8 patients developed severe respiratory complications or died.

Cancer

The risk for cancer patients during a COVID-19 pandemic has also been discussed. “Several classes of cancer treatment, including chemotherapy and immunotherapy, can suppress immune systems and make patients more susceptible to COVID-19 infection,” writes Extance. [4]

Out of the 1,590 cases of COVID-19 studied in China, 18 patients had cancer. “Early published reports from China on the outcomes of patients with cancer infected with COVID-19 indicated a 3.5 times higher risk of needing mechanical ventilation or ICU admission or dying compared with patients without cancer,” writes Liang and colleagues. [5]

Lyme disease

It’s been stressful for Lyme disease patients and their families until we know more about their risks of COVID-19.

Fortunately, the antibiotics used to treat Lyme disease do not have an iatrogenic effect, as seen with corticosteroids and immunosuppressive drugs.

For now, it is important to continue universal precaution, to eat right, and avoid stress. Be careful to avoid another tick bite. And make sure you continue to receive treatment for your Lyme disease.

Hydroxychloroquine and azithromycin for COVID-19 may be effective

COVID-19: Transmission from patient to health care worker

What is the risk for children with COVID-19?

References:

Guan WJ, Liang WH, Zhao Y, et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis. Eur Respir J. 2020.
Favalli EG, Ingegnoli F, De Lucia O, Cincinelli G, Cimaz R, Caporali R. COVID-19 infection and rheumatoid arthritis: Faraway, so close! Autoimmun Rev. 2020:102523.
Monti S, Balduzzi S, Delvino P, Bellis E, Quadrelli VS, Montecucco C. Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies. Ann Rheum Dis. 2020.
Extance A. Covid-19 and long term conditions: what if you have cancer, diabetes, or chronic kidney disease? BMJ. 2020;368:m1174.
Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335-337.

Comments

30 responses to “Risks for Lyme disease patients during a COVID-19 pandemic. A perspective.”

Tricia Bown

11/22/2020

Dr Cameron, this may sound far fetched but here goes anyway. As many of us lymies know, we can relate to long haulers syndrome. Has the following question ever crossed your mind? Could the hundreds of thousands of long haulers be in fact victims of undiagnosed Lyme disease that was triggered by covid-19? Isn’t it known that traumatic events, mental or physical, can trigger Lyme? The symptoms are eerily similar. Surely I can’t be the only one that have these thoughts. Have any covid patients with lingering symptoms been tested for Lyme? Lyme is also a world pandemic, is it not? Your thoughts would be greatly appreciated.

Reply
1. Dr. Daniel Cameron
  
  11/23/2020
  
  I am also concerned. I am afraid Lyme disease patients will be dismissed another illness e.g. fibromyalgia and chronic fatigue. We can add COVID-19 to the list.
  
  Reply
2. Alison
  
  10/03/2021
  
  I got covid in Dec mild case but became fatigued and weak as time went on took J &J in April and became much more weaker and fatigued, … in September I went to a MD who practices functional medicine and spent thousands and specialized testing and I tested positive for Lyme disease.
  
  Reply
Cleve

11/20/2020

Shortly after a knee replacement, I started to get very ill. The surgeon assured me it had nothing to do with my surgery. I started to see every doctor known to man. Finally I went to a doctor who said I had Lyme disease. I have tried every treatment there was. It has been 8 years since my surgery, and have felt sick every day with to many symptoms to list.I Iive a miserable existence, and no one in my family has the slightest clue what Lyme does to you.

Reply
Emily

09/28/2020

I am 12 and I got Lymes Diseases last year. Will it be worse for me if I get covid?

Reply
1. Dr. Daniel Cameron
  
  09/28/2020
  
  I have followed Lyme disease patients who are ill with COVID-19. My patients have not been worse. My colleagues have not seen that Lyme disease patients have more troubles with COVID-19. I advise my patients to extra careful to avoid COVID-19 out of an abundance of caution.
  
  Reply
Valencia

07/27/2020

My husband tested positive for Lyme and multiple co-infections (we did the test ourselves via IgeneX). We live in Canada and we are trying to get diagnosed / treated here but it’s a nightmare. He is currently NOT receiving ANY treatment. Would catching COVID-19 be a very big risk to his health?

Reply
1. Dr. Daniel Cameron
  
  07/28/2020
  
  I have been in touch with a number of my Lyme disease patients who have been infected with COVID-19. They have not been worse than individuals in their family without Lyme disease. We could use a study. I advise my patients to take extra precautions with Lyme disease and COVID-19 until we know more.
  
  Reply
2. Milt Mankoff
  
  03/22/2021
  
  A friend had Covid and appeared to be a “long hauler,” with symptoms of fatigue months after Covid appeared. For some reason, his doctor checked him for Lyme and discovered he had a case that must have been dormant for years because he was never aware of having it. A course of antibiotics ended all of his symptoms. I’m not sure if doctors routinely check for Lyme now, but perhaps they should. On the off-chance they normally don’t;t I thought I’d post this here.
  
  Reply
Leah Olson

07/22/2020

About 6 weeks ago I was tick bitten a second time. I’m a teacher and am getting ready to go back to school even though I’ve been sick all summer. What should I do? Should I go back to see students in person?

Reply
1. Dr. Daniel Cameron
  
  07/22/2020
  
  I would evaluate a patient presenting with the same story for Lyme disease and COVID-19 or both at the same time. I would also evaluate them for other illnesses.
  
  Reply