covid positive on 40 mg of pred

[Jlml]

Good afternoon,

I hope you are all well and had a good Xmas.

I have tested positive for covid this morning and I am on 40 mg of pred.

Do I need to adjust my dose or .?.

Thank you for your help.

[SnazzyD]

Oh dear, there is so much of it about. If it were me I’d be getting medical advice with the Covid as the context. There are considerations with both increasing and decreasing and it may be best to stay put. We are not experts in the treatment of Covid and it may be that docs would want to give you Covid combating drugs too. Sick day rules in the adrenal sense are not applicable here because of the high dose.

[ab58sf in reply to SnazzyD]

I agree. I did not change my dosage when I got Covid. Actually, when I had Covid the first 5-6 days, I had no PMR pain. But, it came back with a vengeance after I got better. I am now on 3mgs when I had been down to 1.5. Pain still with me every day, but I am hesitant to go higher than 3mgs due to possible eye concerns.

[PMRpro Ambassador]

You do need medical advice - but you shouldn't need to increase the pred as it is well above the maximum Sick Day Rules level.

If you are on 40mg, I assume your diagnosis is GCA? You shouldn't change the dose there until your rheumy tells you - are you under one and have you a helpline? If you are you could try asking for advice.

It would also be worth enquiring about antiviral medication - you would qualify at such a high dose. Call the 119 line for them to advise.

nhs.uk/conditions/coronavir...

And get well soon xxx

[Jlml in reply to PMRpro]

Thank you.

Rheumatology rang today to say guidelines are not to change dose but if I get worse over the next couple of days an antiviral will be issued. The hospital are supposed to ring tomorrow to discuss.

Hopefully it won’t be needed.

[PMRpro Ambassador in reply to Jlml]

Wonder what guidelines they use - at your dose no, but below 20mg it is a different matter

Hopefully not - how are you feeling?

[Jlml in reply to PMRpro]

Hi PMRpro,

A bit chesty but primarily more like flu. Achey, runny nose, no energy , headache and cough.

Muscles in back hurt when cough.

Started more chesty and sore throat but that seems to be subsiding.

I am trying to rest as much as possible as my body has a lot on at the moment. Still awaiting results from the Tests for GCA which hopefully will be next week. I am not good at sitting around 😩

[posthinking01]

I was put on 200 mg of HC in hospital with Sepsis - why has a Dr not told you what to do re getting sick.

[Jlml in reply to posthinking01]

sorry to sound dim but what is HC ?

I am hopefully talking to the hospital today (if they call) but I am hoping my body will cope and antivirals won’t be needed. We will see x

[posthinking01 in reply to Jlml]

Hi I must add that I am a Lupus patient with adrenal issues too - HC is hydrocortisone. We have it drummed into us about the 3 day sick rules. Not sure what you are supposed to do with your problems though - but reason I said what I said is that if you are on steroids then you have to up them when you get ill because the body will be shocked by the reduction when you get ill - but take advice.

[PMRpro Ambassador in reply to posthinking01]

Yes, but not when you are already on 40mg pred. The SDRs are to double to dose up to a maximum of 20mg/day - i.e. if you are on 10 -19mg you up the daily dose to 20mg, no more.

[posthinking01 in reply to PMRpro]

I didn't know that so thanks - I must admit I have an injection kit too which is 100 mg of HC to inject if I have an adrenal crisis which could be life threatening but didn't know about the Pred issues so will check that out - thank you.

[PMRpro Ambassador in reply to posthinking01]

Patients on pred under 10mg are also at risk of adrenal insufficiency in a stressful situation - emotional, physical or illness. Some on lower doses of pred under 5mg may be tested and be given an HC rescue pack but it isn't that common. But a higher doses there is little need for more, pred and HC are both corticosteroids and do the same thing.

[posthinking01 in reply to PMRpro]

You are so right about emotional - I have problems with that side of things more than anything else - it is a horrible deficiency to have - even the sun or a hot day I have to gauge my adrenals are coping as the sun with the Lupus is seen by my body as a stressor. Nightmare - never mind - still here ! thanks for info very informative.

[Pass7]

I didn’t have to reduce my prednisone but doctor told me to hold my methotrexate that week.

[MiniSpec]

I'm sure I read somewhere that patients with Covid have been given corticosteroids when in hospital, so you're already on the right medication to help combat the Covid. As your dose is so high, I would just say carry on as you are, but ask your doctor/rheumy for any further advice regarding dosage if you think it might need changing.

[Hrblock57]

Doctor should be the only person advising you on this . Ask the pharmacist too just to get an idea until you find your doctor.

Specially if you are taking the paxlovid the covid virus pills.

[Jlml]

Thank you everyone.

I am much better now thank you, just a bit chesty. I actually only tested positive for 3 days but was poorly for about 6. I didn’t accept the anti-virals so fought it on my own.

When I had covid about a year ago I tested positive for about 10 days , most bizarre but happy with the outcome.

Hubby now has flu/cold bug so trying to avoid that 🙏🙏

Happy New Year to you all x