Immunocompromised, Autoimmune diseases, and Adult JRA Remission: What it means for Social Distancing in the time of COVID-19

Juvenile Rheumatoid Arthritis (I have poly onset JRA)

  • Classified autoimmune disease
  • Chronic inflammation
  • Malfunctioning of immune system targeting lining of joints called synovial membrane.

It is much more common for other subforms of JRA like poly-onset to persist into adulthood, despite many with poly-onset entering long-term remission. Joint pain of purely biomechanical origin is common (stemming from cartilage loss, bone erosion etc) despite clinical remission. This can be hard to differentiate from general morning stiffness.

(See Table 3. Medical problems in adults with juvenile rheumatoid arthritis.)

Table 3. Medical problems in adults with juvenile rheumatoid arthritis.
Peter A. Nigrovic, and Patience H. White, “Table 3. Medical Problems in Adults with Juvenile Rheumatoid Arthritis,” “Care of the Adult With Juvenile Rheumatoid Arthritis,” in Arthritis & Rheumatism (Arthritis Care & Research) Vol. 55, No. 2, April 15, 2006, American College of Rheumatology, pp 208–216. DOI 10.1002/art.21857

Some Orthopedic and Psychological consequences of adults with JRA

  • Leg length discrepancy
  • TMJ ( temporomandibular joint) and can also be symptomatically silent
  • Anxiety and depression, which can also cause insomnia

My conclusion:

With Juvenile arthritis being a chronic autoimmune disease, despite my clinical remission and my lack of ever taking immunosuppressants to treat JRA, I would be considered to be slightly immunocompromised, but not fully immunocompromised because of my relatively healthy state. As in, I should take slightly more precautions than normal, but not excessive. While taking excessive precautions are safer for those that are considered immunocompromised in any capacity, I still have a higher chance of contracting COVID-19, getting an aggressive version, or easily spreading it to others. This is why I stay home. Primarily for my own health and safety, but also for my parents who are over 50, my dad and sister with T1 Diabetes, my friends who have JRA and autoimmune diseases, and all of the strangers that could also be part of the vulnerable populace.

Take for example my friend who gets infusions to manage their type of JA. The infusions they take (immunosuppressants) makes them immunocompromised, but if they avoid taking the infusions for fear of the virus, they risk a flare and longterm adverse affects, including high risk of contracting additional external illnesses. In the end its better for them to get the infusion and practice social distancing and quarantine because they are immunocompromised.

Resources and Further Reading


Peter A. Nigrovic, and Patience H. White, “Care of the Adult With Juvenile Rheumatoid Arthritis,” in Arthritis & Rheumatism (Arthritis Care & Research) Vol. 55, No. 2, April 15, 2006, American College of Rheumatology, pp 208–216. DOI 10.1002/art.21857

Coronavirus and Arthritis: What You Need to Know,” Arthritis Foundation, March 2020. (UPDATED REGULARLY)

“Five Things A Rheumatologist Needs to Know About Adults With Juvenile Idiopathic Arthritis,” in American College of Rheumatology,

Yuwen, Weichao, and Ward, Teresa, and Landis, Carol, and Ringold, Sarah, and Wallace, Carol. “SLEEP DISTURBANCE, PAIN, AND FATIGUE IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS.” in Journal of Pediatric Psychology Advance Access published December 27, 2007.
Also published additionally as Conference: 2014 Western Institute of Nursing Annual Communicating Nursing Research Conference (April 13, 2013), 1-10.