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COVID-19 Guidance

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The American College of Rheumatology (ACR) has developed clinical guidance in the context of the COVID-19 pandemic, including for the care of adult and pediatric patients with rheumatic diseases, as well as for the management of inflammatory syndromes in children with recent or concurrent infections with SARS-CoV-2, specifically Multisystem Inflammatory Syndrome in Children (MIS-C).

Vaccine Clinical Guidance for Patients with Rheumatic and Musculoskeletal Diseases

The ACR has developed guidance for rheumatology providers on the use of the COVID-19 vaccine for patients with rheumatic and musculoskeletal diseases (RMDs). All recommendations are based on current knowledge and will be revised as circumstances and evidence evolve.

COVID-19 Vaccine Clinical Guidance Summary – Version 5 Revised

Updated August 12, 2022

American College of Rheumatology Guidance for COVID-19 Vaccination in Patients with Rheumatic and Musculoskeletal Diseases – Version 5

Published November 8, 2022
How to cite this article: Curtis JR, Johnson SR, Anthony DD, Arasaratnam RJ, Baden LR, Bass AR, et al. American College of Rheumatology Guidance for COVID-19 Vaccination in Patients with Rheumatic and Musculoskeletal Diseases – Version 5. Arthritis Rheumatol 2022 e1-e16. doi: https://onlinelibrary.wiley.com/doi/10.1002/art.42372

Resources related to the COVID-19 vaccine guidance:

ACR on Air Podcast episode with lead author Jeffrey Curtis, MD, MPH

ACR COVID-19 Vaccine Guidance Recommends Vaccination, Addresses Immunosuppressant Drugs & Patient Concerns
February 10, 2021

ACR on Air Podcast episode with lead author Jeffrey Curtis, MD, MPH

COVID-19 Updates: Vaccine 3rd Doses, Antibody Testing & Real-World Data
September 28, 2021

ACR COVID-19 Vaccine Guidance Town Hall Recording

February 16, 2021

Press Release: ACR COVID-19 Vaccine Guidance Recommends Vaccination, Addresses Immunosuppressant Drugs & Patient Concerns

February 11, 2021

Press Release: ACR Releases Updated COVID-19 Vaccine Clinical Guidance Including Timing 3rd Doses with Immunomodulatory Drugs

August 23, 221

Press Release: Fifth Update of ACR COVID-19 Vaccine Guidance Supports Fourth Doses for High-Risk Rheumatic Disease Patients

February 2, 2022

Clinical Guidance for Adult Patients with Rheumatic Diseases

Clinical guidance for the care of adult patients with rheumatic diseases during the COVID-19 pandemic includes patients with a documented COVID-19 infection, those who are stable following exposure to SARS-CoV-2 (but without known infection), and patients who are stable with no infection or exposure. The recommendations address various treatment options and provide general guidance, as well as direction for when to start, stop, or reduce medications. All recommendations are based on current knowledge and will be revised as circumstances and evidence evolve.

COVID-19 Clinical Guidance Summary for Adult Patients with Rheumatic Diseases

Updated February 1, 2021

American College of Rheumatology Guidance for the Management of Rheumatic Disease in Adult Patients During the COVID-19 Pandemic: Version 3

Published December 5, 2020
How to cite this article: Mikuls TR, Johnson SR, Fraenkel L, Arasaratnam RJ, Baden LR, Bermas BL, et al. American College of Rheumatology Guidance for the Management of Rheumatic Disease in Adult Patients During the COVID‐19 Pandemic: Version 3. Arthritis Rheumatol 2021; 73; e1-e12. doi: https://onlinelibrary.wiley.com/doi/10.1002/art.41596.

Clinical Guidance for Pediatric Patients with Rheumatic Diseases

The clinical guidance documents for pediatric patients in the context of the COVID-19 pandemic include the care of children with pediatric rheumatic disease and management of inflammatory syndromes in children with recent or concurrent infections with SARS-CoV-2, specifically Multisystem Inflammatory Syndrome in Children (MIS-C). All recommendations are based on current knowledge and will be revised as circumstances and evidence evolve.

The recommendations for pediatric rheumatology patients address various treatment options and provide general guidance, as well as direction for when to start, stop, or reduce medications.

COVID-19 Clinical Guidance Summary for Pediatric Patients with Rheumatic Disease – Version 2

Updated June 25, 2021

ACR Guidance for the Management of Children with Pediatric Rheumatic Disease During the COVID‐19 Pandemic: Version 2

Published June 10, 2021
How to cite this article: Wahezi DW, Lo MS, Rubinstein TB, Ringold S, Ardoin SP, Downes KJ, et al. American College of Rheumatology Guidance for the Management of Children with Pediatric Rheumatic Disease During the COVID‐19 Pandemic: Version 2. Arthritis Rheumatol 73; 2021; e46-e59. doi: https://onlinelibrary.wiley.com/doi/10.1002/art.41772

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The recommendations for MIS-C focus on general guidance, diagnostic evaluation, and therapy options, as well as comparing and contrasting the features of MIS-C and Kawasaki Disease. For hyperinflammation in COVID-19, the recommendations also focus on general guidance, as well as immunomodulatory treatment.

Clinical Guidance Summary for Pediatric Patients with MIS-C Associated with SARS-CoV-2 and Hyperinflammation in COVID-19: Version 3

Updated February 3, 2022

ACR Clinical Guidance for Pediatric Patients with Multisystem Inflammatory Syndrome in Children (MIS‐C) Associated with SARS‐CoV‐2 and Hyperinflammation in COVID‐19: Version 3

Published February 3, 2022
How to cite this article: Henderson LA, Canna SW, Friedman KG, Gorelik M, Lapidus SK, Bassiri H, et al. American College of Rheumatology Clinical Guidance for Pediatric Patients with Multisystem Inflammatory Syndrome in Children (MIS‐C) Associated with SARS‐CoV‐2 and Hyperinflammation in COVID‐19: Version 3. Arthritis Rheumatol 2022; 74: e1-e20. doi: https://onlinelibrary.wiley.com/doi/10.1002/art.42062.

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