consultqd.clevelandclinic.org/oncology-pharm… ClevelandClinicNews Cleveland Clinic MD #clecliniccancer Jame Abraham, MD, FACP Pauline Funchain Simon Mucha Lucy Boyce Kennedy Amy Kunchok

Another great meeting of our ACR/EULAR irAEs group. Much progress has already been made but still much work remains to be done. We continue… EULAR American College of Rheumatology #ACR24 Tamiko Katsumoto Jan Leipe Maria Suarez-Almazor Cassandra Calabrese alexa meara Ernest Choy Nilasha Ghosh & cols

How to save our specialty from burnout. Burnout Is a poison. #cleclinicrheum #acr24, Cleveland Clinic American College of Rheumatology Healio Rheumatology Elaine Husni #empathy Leonard Calabrese

🗣️ "Rheumatology has a manpower problem" Leonard Calabrese starts the morning off at #ACR24 with a talk on 🔥#burnout Stay tuned for our coverage 👇 bit.ly/3tQAt48

Saying hi to Cassandra Calabrese at #ACR24 Follow our coverage👉 bit.ly/3tQAt48

A full house for Leonard Calabrese knocking down what we know about long COVID and IMIDS #ACR24 Cassandra Calabrese

#ACR24 in DC with our wonderful #CleClinicRheum family! Leonard Calabrese And congrats to Dr. Carol Langford as incoming ACR president 🌟

Love my #cleclinicrheum family Leonard Calabrese Elaine Husni Adam J Brown Healio Rheumatology American College of Rheumatology #ACR24

We appreciate the hard work and challenges to develop criteria that are both 'all inclusive' but with sufficient specificity to accommodate pt care & research -ie no one left behind BUT have concerns re implementation especially for Dx of 'autoimmune' #LongCovid ClevelandClinicNews

We recognize the strong evidence of COVID induced auto-Abs especially in those with more severe forms but recognize this is NOT specific to this virus and does not clearly correlate with specific clinical endotypes - preclinical models are important but insufficient as of now

Epidemiologic studies using EMR are meritorious but limited especially for lack of validation in identifying rare 'autoimmune /IMID" dx's- even within the corpus of published studies there are inconsistencies- false discovery with prevlent autoAbs ie ANAs- must be considered

At the same time new diseases ie MIS-C MIS-A MIPC ( MDA-5 pneumonitis) are important and still incompletely understood. Anti-MDA-5 disease may not be linked to infection and its possible relationship to vaccine exposure is incompletely understood

Clearly not all/most patients with new /incident autoimmune disease diagnosed in the COVID era will have #LongCOVID but the definition allows ( as no time limit from incident infection is stated) for the consideration and application of such if judgement warrants

Application of IOM criteria to individual patients s/p #Covid19 requires critical appraisal of the patient ie their disease infection/vaccine history/pre-existing conditions/clinical endotype/lab etc and the strength of their association w #LongCovid will likely change over time

Rheumatologists and other clinicians caring for patients with Immune Mediated Inflammatory Diseases IMIDS- will face challenges with the current definition which will change over time - We that the IOM for their work Eric Topol zeynep tufekci