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EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2
  1. Robert BM Landewé1,2,
  2. Pedro M Machado3,
  3. Féline Kroon4,
  4. Hans WJ Bijlsma5,
  5. Gerd R Burmester6,
  6. Loreto Carmona7,
  7. Bernard Combe8,
  8. Massimo Galli9,
  9. Laure Gossec10,11,
  10. Annamaria Iagnocco12,
  11. John D Isaacs13,
  12. Xavier Mariette14,15,
  13. Iain McInnes16,
  14. Ulf Mueller-Ladner17,
  15. Peter Openshaw18,
  16. Josef S Smolen19,
  17. Tanja A Stamm20,
  18. Dieter Wiek21,
  19. Hendrik Schulze-Koops22
  1. 1 Amsterdam Rheumatology Center, AMC, Amsterdam, The Netherlands
  2. 2 Rheumatology, Zuyderland MC, Heerlen, The Netherlands
  3. 3 Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, UK
  4. 4 Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  5. 5 Rheumatology, UMCUtrecht, Utrecht, The Netherlands
  6. 6 Rheumatology and Clinical Immunology, Charité University Hospital, Berlin, Germany
  7. 7 Depratment of Rheumatology, Instituto de Salud Musculoesquelética, Madrid, Spain
  8. 8 Immunorhumatologie, CHU Lapeyronie, Montpellier, France
  9. 9 Department of infectious diseases, Universita degli Studi di Milano, Milano, Lombardia, Italy
  10. 10 Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Universite, Paris, France
  11. 11 APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France
  12. 12 Scienze Cliniche e Biologiche, Università degli Studi di Torino, Torino, Italy
  13. 13 Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Institute of Cellular Medicine, Newcastle upon Tyne, UK
  14. 14 Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux universitaires Paris-Sud – Hôpital Bicêtre, Le Kremlin Bicêtre, France
  15. 15 3Université Paris-Sud, Center for Immunology of Viral Infections and Auto-immune Diseases (IMVA), Institut pour la Santé et la Recherche Médicale (INSERM) UMR 1184, Université Paris-Saclay, Le Kremlin Bicêtre, France
  16. 16 Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
  17. 17 Rheumatology and Clinical Immunology, Giessen University, Bad Nauheim, Germany
  18. 18 National Heart & Lung Institute, Imperial College London Faculty of Medicine, London, London, UK
  19. 19 Department of Rheumatology, Medical University of Vienna, Wien, Austria
  20. 20 Section for Outcomes Research, Medical University of Vienna, Vienna, Austria
  21. 21 Deutsche Rheuma-Liga, Bonn, Germany
  22. 22 Division of Rheumatology and Clinical Immunology, Department of Medicine IV, Ludwig Maximilian University of Munich, Munich, Germany
  1. Correspondence to Professor Robert BM Landewé, Amsterdam Rheumatology Center, AMC, Amsterdam 1105 AZ, The Netherlands; landewe{at}


The provisional EULAR recommendations address several aspects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus, and the disease caused by SARS-CoV-2, COVID-19 and are meant for patients with rheumatic and musculoskeletal diseases (RMD) and their caregivers. A task force of 20 members was convened by EULAR that met several times by videoconferencing in April 2020. The task force finally agreed on five overarching principles and 13 recommendations covering four generic themes: (1) General measures and prevention of SARS-CoV-2 infection. (2) The management of RMD when local measures of social distancing are in effect. (3) The management of COVID-19 in the context of RMD. (4) The prevention of infections other than SARS-CoV-2. EULAR considers this set of recommendations as a ‘living document’ and a starting point, which will be updated as soon as promising new developments with potential impact on the care of patients with RMD become available.

  • antirheumatic agents
  • health services research
  • epidemiology
  • quality indicators, health care
  • patient care team

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  • Handling editor David S Pisetsky

  • Twitter @pedrommcmachado, @ProfJohnIsaacs

  • Contributors All authors are members of EULAR’s task force for the development of recommendations for patients with RMD in the context of SARS-CoV-2 and COVID-19. They all have contributed to the work and read and finally approved the manuscript for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests RBML received honoraria for lecturing and consultation from AbbVie, Amgen, BMS, Celgene, Galapagos, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, UCB and is owner and director of Rheumatology Consultancy BV. PMM received consulting/speaker’s fees from Abbvie, BMS, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Roche and UCB and is supported by the National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre (BRC). The views expressed are those of the authors and not necessarily those of the (UK) National Health Service (NHS), the NIHR, or the (UK) Department of Health. LG received research grants from Lilly, Pfizer, Sandoz; and consulting fees from AbbVie, Amgen, BMS, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Sanofi-Aventis and UCB. GRB received honoraria for lectures and consulting from AbbVie, Amgen, BMS, Gilead, Janssen, Lilly, Novartis, Pfizer, Sanofi-Aventis, Roche, UCB. XM received consulting fees from BMS, Gilead, Janssen, Pfizer, Samsung, UCB. BC received honoraria from AbbVie, BMS, Gilead, Janssen, Lilly, Merck, Novartis, Pfizer, Roche-Chugai, Sanofi and UCB; and research grants from Novartis, Pfizer and Roche. JSS received grants to his institution from Abbvie, AstraZeneca, Janssen, Lilly, MSD, Pfizer and Roche and provided expert advice for, or had symposia speaking engagements with, AbbVie, Amgen, AstraZeneca, Astro, Bristol-Myers Squibb, Celgene, Celltrion, Chugai, Gilead, ILTOO Pharma, Janssen, Lilly, MSD, Novartis-Sandoz, Pfizer, Roche, Samsung, Sanofi and UCB. JDI received research grants from Pfizer and honoraria for lectures and/or consulting from AbbVie, Amgen, Eli Lilly, Gilead, Merck & Co, Roche and UCB. MG received honoraria for lectures and consulting and grants to his institution: AbbVie, BMS, Gilead, Janssen, Novartis, MSD, AstraZeneca, ViiV. HS-K received honoraria for lectures and consulting from AbbVie, Amgen, BMS, Gilead, Janssen, Lilly, Novartis, Pfizer, Sanofi-Aventis, Roche and UCB. IM received research grants from Lilly, Pfizer, BMS, Celgene, Janssen; and consulting fees from AbbVie, BMS, Celgene, Gilead, Janssen, Lilly, Novartis, Pfizer, Sanofi-Aventis and UCB.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.