COVID-19 and Autoimmune Disease: Common Sense Practices to Stay Healthy

The global spread of SARS-CoV-2 (the virus that causes coronavirus disease 2019 or COVID-19) has disrupted lives and left many of us feeling anxious. Much of the anxiety comes from all of the uncertainty surrounding this new disease. And while doctors, scientists, epidemiologists and other public health experts and policy makers around the world are working hard to better understand the virus, contain it, develop treatments and an effective vaccination, plenty of uncertainty remains. As someone with autoimmune disease, this uncertainty can be extra unsettling. 

Undoubtedly you have read numerous articles about social distancing and extra vigilance in hand washing to reduce your risk of exposure to the virus. But is there more you can do to help protect yourself? Following the guidelines published by the CDC to reduce your risk of getting sick is an important step to protecting yourself. 

Mymee would like to share other common sense behavioral practices that can help to maximize your health, reducing the chances that you will get seriously ill from SARS-CoV-2 or, importantly, other infections like influenza (which has affected between 36-51M Americans this season and has caused 22,000-55,000 deaths). 

1. Eat a balanced, nutrient-rich diet, full of colorful fruits and vegetables. Make sure to get enough lean protein (the guideline is about two four-ounce servings per day, ideally from animal protein raised without antibiotics or plant-based proteins such as beans, nuts, and seeds). Cut way back on highly-processed foods and refined starches (i.e. cut out sugary baked goods, processed white bread, white rice, etc). 
2. Stay well-hydrated. Drink water or caffeine-free tea/herbal tea, a minimum of 64 oz per day. Eliminate sugary drinks like soda and fruit juice (better to eat whole fruit). 
3. Drink alcohol in moderation, if at all.
4. Get an adequate amount of sleep nightly. For most people this is a minimum of 7 uninterrupted hours of sleep. Some data suggests that the hours of sleep one gets before 10 pm are especially helpful in achieving a fully restorative night’s sleep. So put the electronics away and turn the lights out by 10 pm.
5. Make regular exercise a priority. This can be especially difficult for some people, whether due to physical limitations, pain, or simply time constraints. And now it may be even more difficult as fitness centers close their doors around the country. But you don’t have to get on an elliptical machine or Stair Master to get exercise. In fact, getting outdoors and taking a brisk walk not only has the benefit of cardiovascular exercise, it can also bring a sense of peace and calm that is so important for overall health, especially in extra stressful times (see #6 below). Please note data suggests that over exercising can at least temporarily impede optimal immune function. So don’t feel that this is the time to start a new, super-vigorous exercise program. 
6. Develop a daily practice that helps you manage stress. This outbreak is a stark reminder that stress, in many unpredictable forms, will impose itself on our lives. Each person must develop and then practice, daily, their own stress management techniques. Only you know what works best for you to take a step back from the grind of daily life, clear your mind, center yourself and give you a sense of peace. For some it’s meditation, even just 10 minutes a day. For others it is listening to music, taking a bath, or simply being in nature for some quiet, contemplative time. Breathing deeply and mindfully is a quick, accessible method you can use anytime throughout the day to create inner calm when you feel overwhelmed. So use deep breathing throughout the day and find at least 10 minutes you can devote to you each day and use it for stress relief.     
7. Ask your doctor before changing any medications. If you are taking immune-suppressing medication to treat an autoimmune disease, you may be wondering if you should stop this medication to help strengthen your immune system to protect you from SARS-CoV-2. While it seems logical that the chances of having more severe illness from SARS-CoV-2 (or any infection, for that matter) go up if you are taking an immune-suppressing medication, it may not be that simple. In fact, because part of what makes some people with COVID-19  so critically ill is the body’s release of excessive amounts of inflammatory chemicals (referred to as cytokines), some of the drugs used to treat autoimmune conditions (because they limit or block some of those same chemicals) are being tested as treatment for COVID-19. Not enough is known yet to say definitely whether this approach will prove to be widely beneficial. The important take home message is that you should not stop any drug prescribed for your autoimmune condition (or any other medication problems) unless it is at the direction of your doctor. 
8. Take immune-boosting supplements. The internet is loaded with recommendations about vitamin, mineral, and herbal supplements that will help your body fight infections, including SARS-CoV-2. Many of these recommendations have little to no evidence to back them up. However, there are a few supplements that do show promise in maintaining a healthy immune system. These include vitamin D3, vitamin C, zinc, and fish oil. So if you are not taking supplements and are wondering what to try now, or looking to refine what you currently take, I would start with these and follow the recommended dosing on the package.

This is part 4 in our COVID-19 and Autoimmunity Blog Series, read the rest here.

Part 1: Stop Stressing: 5 Tips to Reduce Stress and Boost Immunity During COVID-19

Part 2: Sleep It Off: Why a Good Night's Sleep is Just What the Doctor Ordered

Part 3: Gut Feeling: What Gut Health Can Do For Your Immune System

Part 4: The Facts about Hydroxychloroquine (Plaquenil) Shortages

Part 5: COVID-19 and Autoimmune Disease: Common Sense Practices to Stay Healthy

Stay healthy!