However, it was a non-randomized trial with a small sample size . (RA) is the most common immune-mediated disorder in COVID-19 patients, and in this review, we discuss how the commonly used drugs in RA alter the patients susceptibility to this contamination. The review also summarizes the recommendations from the major bodies on how to manage this disease in these times. Key Points ? em Patients on immunosuppressive medications are not found to be at a greatly increased risk of acquiring COVID-19 contamination. /em em ? Patients doing well on a stable dose of steroid and/or Disease-Modifying Antirheumatic Drugs (DMARDs) should be allowed to continue the same unless they get infected in which case, temporary stoppage of methotrexate and leflunomide may be considered. /em em ? Initiation of high-dose steroids, DMARDs, and biologics, if the clinical situation demands so, can be done. /em em ? Maintenance biologic therapy for stable patients should be individualized by the treating physician. /em Open in a separate window strong class=”kwd-title” Keywords: COVID-19, Management, Rheumatoid arthritis, Treatment Introduction The outbreak of coronavirus contamination throughout the Retigabine (Ezogabine) world is usually a matter of global emergency. Patients with comorbidities, in their old age, and with a compromised immune system are at the highest risk of mortality. Patients with autoimmune diseases, like lupus and rheumatoid arthritis (RA), already have a compromised immune system which is usually coupled with the prescribed immunosuppressive brokers they takemaking them more susceptible to infections. Patients on immunosuppressants may present atypically; for example, patients on steroids may not mount a febrile response and patients on IL-6 inhibitors may not have a rise in inflammatory markers . Another clinical challenge which may present while treating RA patients is the overlap of symptoms which may occur between the flare of RA and COVID-19 infections. Symptoms like myalgia, arthralgia, fever, and elevated inflammatory markers may occur in both cases. An exacerbation of RA-associated Interstitial Lung Disease (RA-ILD) can mimic symptoms of COVID-19 contamination. COVID-19 testing by real-time polymerase chain reaction (RT-PCR) should be used to differentiate the two cases in such scenarios. In a retrospective study done to analyze the clinical characteristics of COVID-19 infections in patients with and without ILD, ten out Retigabine (Ezogabine) of 28 patients with ILD had connective tissue disease- ILD. A higher proportion of patients with ILD presented with cough, dyspnea, diarrhea, fatigue, neutrophil and monocyte counts, interleukin-8, 10, 1, and d-dimer KT3 tag antibody levels as compared with patients without ILD . Although there Retigabine (Ezogabine) is currently no evidence to prove that patients with autoimmune disorders or on immunosuppressive drugs are at a greater risk of contracting the COVID contamination, there remains a theoretical risk of increased complications in such patients if they acquire the contamination . However, data from the COVID-19 Global Rheumatology Alliance Global Registry which gives live time information regarding rheumatic diseases and COVID-19 showed that as of on 17 August, 2020, the commonest rheumatic disease in which COVID-19 was documented was RA (694 patients out of 1783) . Based on a few other studies, rheumatoid arthritis seems to be the most common rheumatic disease in which COVID-19 contamination has been documented [3, 5]. In a Chinese case series of 5 patients with rheumatic diseases who developed COVID-19, four of them had RA and one had systemic sclerosis. Retigabine (Ezogabine) Retigabine (Ezogabine) In another case series from New York, in which 86 patients with immune-mediated inflammatory diseases who contracted COVID-19 were studied, a high percentage of the admitted patients had RA . Rheumatoid arthritis is one of the most common diseases a rheumatologist encounters in their practice. Individuals with rheumatic diseases are on immunosuppressive brokers and require special consideration in the COVID-19 era. An increased risk of contamination in RA as compared with the general population has been documented. A.