Rheumatology through the lens of COVID-19
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On May 22 to 23, I hosted the ninth biennial Biologics Therapies Summit at the Cleveland Clinic — virtually. To say the least, it was very different from past summits.
First, because of the fact that it was virtual (hopefully for the first and last time), second because it was free and we smashed all attendance records with over 1,300 registrants from all over the world, and third because we focused heavily on the COVID-19 connection with autoimmunity. It seems surreal that when the last summit was held in June of 2019, COVID-19 did not exist.
Now, a short 2 years later, it has changed our world, including our rheumatology world, and has resulted in an outpouring of well over 150,000 published scientific articles, a number which grows by the minute. Who knows what we will be talking about in 2 years? While I expect that COVID-19 will not go quietly, it will perhaps no longer be the scientific maelstrom it is at the moment.
I really can’t condense the conference into this editorial but, suffice it to say, we still have a lot to learn. In terms of COVID-19 and our patients, the news is not that great as it seems clear that our patients (not surprisingly) do not appear to do as well as non-rheumatic disease matched individuals and that many of our drugs are complicit in this effect.
In fact, there are some data that suggest that rheumatic disease patients may actually be more susceptible to getting the infection itself (not just more severe disease), though, in my opinion, this is more likely a manifestation of increasing the incidence of symptomatic vs. asymptomatic COVID-19 disease in a vulnerable population.
In terms of vaccine response, the glass is either half-full or half-empty depending on your perspective. After only the first dozen studies or so, it appears that most of our patients will generate adequate vaccine responses but a considerable portion do not. More importantly, just how vulnerable they are to become infected and developing symptomatic disease as of this writing is undefined. Finally, the spectrum of autoimmune autoinflammatory sequelae resulting from COVID-19 as well as our vaccines is totally a work in progress.
Reflecting over the past year, I can easily say that I have never read more papers, never reviewed as many papers for peer review publications, never written as many papers in a given year and have never (not even close) given more talks. It’s time for a rest. By the time you read this, I will hopefully have taken my first plane ride in 16 months. I hope I remember how to clear TSA. What do you think we will be talking about next time? Let me know your thoughts at calabrl@ccf.org or rheumatology@healio.com.
- For more information:
- Leonard H. Calabrese, DO, is the Chief Medical Editor, Healio Rheumatology, and Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and RJ Fasenmyer Chair of Clinical Immunology at the Cleveland Clinic.
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