Skill Checkup: A 68-Year-Old Woman With Low-Grade Fever, Headache, Body Aches, Fatigue, Nasal Congestion, and Sore Throat

Enrico Brunetti, MD


November 07, 2022

The EULAR guidelines for the management and vaccination of patients with rheumatic and musculoskeletal diseases in the context of SARS-CoV-2 advise that if a patient on long-term glucocorticoid therapy develops suspected or confirmed COVID-19, this treatment should be continued. On the other hand, patients on rituximab should consider postponing the next cycle of treatment.

In general, whether and for how long to hold antirheumatic medications for vaccination remains to be determined for some classes. Recommendations from the American College of Rheumatology have advised holding methotrexate, JAKi, abatacept, and rituximab, and later, MMF, in selected patients with controlled disease.

In addition, this patient should be advised to receive a COVID-19 vaccination in 2-3 months' time once active infections resolve.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.