Methotrexate and covid
This is a complicated one. I have RA and I take .5 ml of methotrexate weekly. I am 69. Otherwise healthy. The situation is that my 90-year-old parents are staying with my sister and her husband who have both come down with covid. I want to go take care of them all with standard precautions, but my wife is concerned that I am too immunocompromised because of the metho. I am fully vaccinated and boosted except for the very last one that deals with omicron. I want to tell my wife that it's okay but she insists I talk to an expert. Anybody out there that would have a studied opinion on the matter? Unstudied? My parents have been exposed probably but are not so far coming down with covid.
I would follow your wife's advice on this one,
. I was fully vaccinated and masked for a conference recently and I still came down with COVID. I am not immunocompromised, but it was still pretty awful. There are many ways in which you can help without exposing yourself. Meals and medication are what they need most. Call or message twice daily to see whether they need anything. You can leave items outside their door. They won't be contagious for long, but they might be weak and tired for a while after. That's when you can step in and take your parents to doctor's appointments, etc. You won't do anyone any good if you also get sick. Stay safe and healthy. Best wishes. - Lori (Team Member) 
Hi
. I'm sure this is a stressful situation and it is great and understandable that you want to take care of your parents. For your protection, I can't provide medical advice over the internet, as each person's case and situation is unique. I do want to share with you this article from the journal Nature on COVID-19 in people with rheumatic conditions: https://www.nature.com/articles/s41584-022-00755-x. It notes that those with rheumatic conditions are at higher risk of infection. The outcomes of infection seem to be associated with small additional risk, but the exact level is largely tied to other individual comorbidities. Your rheumatologist and GP should be able to provide further guidance on your specific case and risk factors. It is a good sign that your parents are not showing any symptoms. They should be able to get at home COVID tests and there is the possibility your sister and her husband were not contagious at the time your parents were with them. Wishing you and your family the best. Richard (RheumatoidArthritis.net Team) 
I agree with the comments above. Somethings I would also consider are:
1. Do you have time in your life to spend a week or longer at home isolated or ill?
2. If you get Covid, you will probably have to temporarily discontinue MTX and any other immunosuppressants you are on. Is your RA/RD activity at a level your are comfortable doing that?
3. Anecdotally, I don’t know the statistics on this, but I have felt coughs from normal URIs and a mild case of Covid have lingered much longer while on MTX. I also take a biologic, so that may have an effect. I get bronchitis that lingers for weeks much easier now.
4. Probably due to 4 immunizations, Evusheld and monclonal antibodies my Covid case in July was pretty mild. The 2 cases of Covid negative bronchitis I had were much worse and lasted longer!
5. IF I could be guaranteed a mild case of Covid, I would actually consider it a way to obtain more antibodies to assist in fighting future, possibly worse strains. I just can’t find that guarantee!
6. Because I had to start/stop MTX for multiple URI, dental infections and immunizations this year, my doctor and I chose to stop it. I’ll maintain on just my biologic and low dose prednisone for now. I’m willing to consider restarting MTX after cold and flu season based on my RA/RD symptoms at that time. Best Healthy Wished to you and your family, Jo
