Does anyone remember the chart that surfaced in the beginning of the covid outbreak? A flow chart that showed what ones risk level looked like . I can't find it or an update of it online.
Wanting to see what perceived risk to someone on biologics is, now that we are all having to "live with covid" How afraid should one be? Are we in the same category of those most at risk like transplant patients or cancer patients on chemo for example?
Any insight would be great!
Thank you.
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Deminem
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I can find lots of flowcharts, but nothing that seems to fit perfectly (and it may have been completely removed perhaps). Can you remember anything more about it? Was it to do with the definition/assessment of CV/CEV?
Severe immunosuppression at the time of vaccination is defined using the guidance and timings stated below
2. Individuals on immunosuppressive or immunomodulating therapy at the time of vaccination including
those who were receiving or had received in the previous 3 months targeted therapy for autoimmune disease, such as JAK inhibitors or biologic immune modulators including B-cell targeted therapies (including rituximab but in this case the recipient would be considered immunosuppressed for a 6-month period), T-cell co-stimulation modulators, monoclonal tumour necrosis factor inhibitors (TNFi), soluble TNF receptors, interleukin (IL)-6 receptor inhibitors, IL-17 inhibitors, IL 12/23 inhibitors, IL 23 inhibitors (note: this list is not exhaustive)
To optimise vaccine use, specialists should take responsibility for providing clear advice to the patient’s general practitioner about the need for a third primary dose of vaccine and the optimal timing.
Dated 24th March 2020 deals with levels of risk (shielding, self-isolating, social distancing)
I remember the ones you mean, and I thought I’d bookmarked them, but obviously not.
What I recall is more of a scorecard system. So you got something like 2 points each for being over 85, being male, being a smoker, being obese, having heart and lung problems, diabetes or asthma. And more points for being on strong cancer treatment of having had an organ transplant (which are very risky). Also being on Rituximab or high doses of steroids.
Then you got a point each for having an immune system disorder, being on a biologic, and a high dose of MTX. And maybe 0.5 for being over 65.
I am on MTX and a biologic, but no other issues. So I”ve never shielded and feel much calmer now that so many people are vaccinated.
I’ve used it many times through the pandemic and never had any issues. It has been reassuring to see my risk reduce. It now shows I am 3 x more likely than a healthy person same age etc to be admitted to hospital, and 3.5 x more likely to die. Last summer that was 7.5 x more likely to die. The section re chemotherapy if you do go on you need to click the drop down and click B if your on biologics and A if it’s just Dmards. There used to be a box to tick for rheumatology but that’s disappeared possibly as a result of studies showing it’s the medication that’s more the issue rather than the condition. It no longer gives you a covid age, it’s all about probabilities
Hi Deminem, there is also a chart on the British Society for Rheumatology's website still, under their Covid guidance, in the section, 'How do I determine if my patient is CEV':rheumatology.org.uk/practic...
Interesting interview on radio 4 earlier. I didn’t catch the name of the doctor who was asked by Evan Davis how previously shielding people should cope with restrictions lifting. He basically said that if you should consider that you are at the same risk now as pre-covid. So if elderly, with comorbidities etc etc then yes be as careful. But if otherwise healthy then basic precautions with vaccinations are all that he would recommend.
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