The article “COVID-19 vaccines: Safety with rheumatoid arthritis” by Sissons (2021) discusses the relationship between the COVID-19 vaccine and rheumatoid arthritis (RA). The author’s main concern is the safety of the vaccination for patients who have this autoimmune disorder and the adverse effects that this disease can have on people with RA. The author alleges that RA subjects people to a more severe COVID-19 disease flow, which is why these individuals should consider vaccination as a way of protecting them from severe symptoms of COVID.
Significance
This article is significant because it links RA and COVID-19, providing advice to patients with RA and potentially helping them avoid having serious complications if they get COVID-19. RA typically affects people after their thirties and I think that RA will not affect me in the future, however, according to the CDC (n.d.), 24% of people in the US have arthritis, and it is the leading cause of disability in the state. Therefore, the population of people who suffer from RA is extensive, and they will benefit from this article because it explains the potential comorbid conditions that one may have after contracting COVID-19 that are linked to RA.
Personal Response
This article was interesting to me because vaccination against COVID-19 is perhaps the most significant topic today, especially due to a large number of people who oppose vaccination altogether. Hence, the author covered an important topic because people with RA need to consider the benefits and potential dangers of both getting vaccinated and potentially having COVID-19, and they need all the information and expert opinion they can have.
I think that the author of this article has sufficiently discussed the specifics of RA and how COVID-19 can affect the patients with these conditions, therefore justifying the need for vaccination for patients with RA. Moreover, the author cites reputable sources, such as The American College of Rheumatology, which specializes in RA research and can be trusted by a reader. Therefore, the author does a good job of explaining the importance of vaccines and citing evidence to support their position. One way of improving this article is by providing more statistics, such as the number of vaccinated individuals in the US, the number of COVID-19 cases, and the percentage of people affected by RA, which would help strengthen the author’s argument.
Description of the Disease
Etiology and Mechanism of Disease
RA is an autoimmune disease, meaning that its mechanism of action is linked to the immune system of the affected individual attacking the body. Typically, the immune system sends antibodies to protect the organs from illnesses; however, with RA, the antibodies attack the healthy tissues of the joints. Due to this, the synovium becomes inflamed and releases chemicals that damage the nearby tissues and bones (Aletaha, & Smolen, 2018). As a result, the joints may be destroyed completely if the condition is left untreated.
Signs and Symptoms
RA can be diagnosed if a patient complains of joint pain and their joints being swollen. Moreover, a few weeks may pass from the onset of the first symptoms to the development of noticeable pain, although in some cases, RA develops more quickly (NHS, n.d.). The smaller joints, such as the ones in the hands and feet, are the ones that are the most affected.
Diagnostic Methods
RA can be diagnosed starting with a physical examination and asking a patient about their symptoms. Generally, the swelling of the joints is noticeable, and if a physician suspects RA, they will order a number of tests to confirm the diagnosis. For example, blood tests such as erythrocyte sedimentation rates, C-reactive protein, and full blood count can show indicators of RA (Scott et al., 2020; Favalli et al., 2020). However, there is no blood test that would allow diagnosing RA directly. Additionaly, Scott et al. (2020) suggest that a blood test measuring the level of rheumatoid inflammation factors is another helpful diagnostic tool. Apart from blood tests, joint scans can allow the physician to notice the inflammation of the joints.
Pathology, Pathophysiology, Systems Affected
RA’s pathology mainly affects the musculoskeletal system of the body. The pathology and pathophysiology of RA are described by the John Hopkins Arthritis Center (n.d.) in the following manner: “RA is characterized by the presence of autoantibodies known as rheumatoid factors (RF) and anti-citrullinated peptide antibodies” (para. 12). This condition affects the musculoskeletal system of the body, although in some cases, it can spread to other systems as well.
Prognosis, Treatments, Chronic State
Generally, RA is a serious condition that has to be treated; otherwise, the joints may become severely damaged. Hence, the patient has to intake medication to reduce the inflammation (Scott et al., 2020; Burmester & Pope, 2017). The range of medications includes anti-inflammatory drugs, steroids, and painkillers. Moreover, RA is a chronic condition, which means that a person affected by it has to learn the practices of self-care and self-management to address the symptoms and reduce the damage to the joints caused by the inflammation. The prognosis for arthritis, in the best-case scenario, is allowing the patient to live an active life and reduce their disability. However, there is no cure for RA, and therefore, the existing medication targets reducing the inflammation and relieving the pain that a person feels.
Public Health Impact
As was mentioned, the CDC (n.d.) notes that 24% of Americans, or one in every four adults, has RA. This means that the disease affects not only the individuals directly but also places a burden on the public healthcare system. According to CDC (n.d.), “in New Hampshire, musculoskeletal conditions (including lower back pain, joint pain, and osteoarthritis) cost the state $22.1 million in insurance claims in 2019” (para. 23). The patients are affected since the majority of them are on disability and are unable to work due to severe pain.
Technological and Research Advancements
Currently, there is no treatment option that would allow curing RA completely as there is no agreement on why this condition occurs in the first place. However, scientists and practitioners work on developing enhanced diagnostic methods and treatment options. For example, Dixon and Michaud (2018) note that technology allows recording data about RA and the experiences of patients with RA more accurately, which can help advance the treatment development. Moreover, technology allows the patients to engage in better and more effective self-management practices since this is an important element of care for a chronic condition. Hence, patients can get advice on how to manage their physical activity, diet, and lifestyle to experience less pain and lead a better life with RA. More research and technology development is needed, however, to enhance the understanding of why this condition occurs and how to address it.
References
Aletaha, D., & Smolen, J. (2018). Diagnosis and Management of Rheumatoid Arthritis.JAMA, 320(13), 1360. Web.
Burmester, G., & Pope, J. (2017). Novel treatment strategies in rheumatoid arthritis.The Lancet, 389(10086), 2338-2348. Web.
CDC. (n.d.). Arthritis. Web.
Dixon, W., & Michaud, K. (2018). Using technology to support clinical care and research in rheumatoid arthritis.Current Opinion in Rheumatology, 30(3), 276-281. Web.
Favalli, E., Ingegnoli, F., De Lucia, O., Cincinelli, G., Cimaz, R., & Caporali, R. (2020). COVID-19 infection and rheumatoid arthritis: Faraway, so close!Autoimmunity Reviews, 19(5), 102523. Web.
Murphy, M. (2021). COVID-19 vaccines: Safety with rheumatoid arthritis.Medical News Today. Web.
NHS. (n.d.). Rheumatoid arthritis. Web.
Scott, D. L., Galloway, J., & Cope, A. (2020). Oxford textbook of rheumatoid arthritis. Oxford University Press.