COVID-19 and Chest and Airways Illnesses
Understand why chest and airways infections like COVID-19 and flu can pose greater risks if you have arthritis
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Infections that attack the airways like COVID-19 and influenza can be more serious for people living with arthritis. Find out why, and what you can do to protect yourself.
People living with arthritis may have a higher chance of serious illness if you pick up an infection like COVID-19 and the flu. Also, some medicines for your arthritis can increase the chance of you being more unwell if you are infected. This page explains how to protect your health, and what to do if you become sick. It also covers the importance of staying up to date with your vaccinations (shots). Always speak to your GP, or specialist doctor like a rheumatologist, if you have questions about your own situation.
Why chest and airways illnesses are a concern if you have arthritis
Some forms of arthritis happen when the body’s natural defences against germs (the immune system) start attacking the body. Many of the medicines used to treat arthritis work by reducing that defence mechanism. These medicines are important to help control arthritis, but they can make it harder to defend against the germs.
This means that when viruses like COVID-19 and influenza affect your chest and airways, it can cause more serious illness for you than for people who don’t have arthritis. It does not mean you should stop your arthritis medicines because stopping suddenly can cause a flare. Always talk to your GP or rheumatologist before making any changes to your treatment.
How to protect yourself
Germs that attack the chest and airways spread through tiny droplets when an infected person coughs, sneezes or breathes. They can also spread by touching surfaces that droplets have landed on. A person can spread an infection before they even feel unwell. You can help to protect yourself from these infections by following these steps.
- Stay up to date with your COVID-19 and flu vaccinations (shots) – speak to your GP or rheumatologist about what is best for you.
- Stay home if you feel sick, so you do not pass the germs on to others.
- Try to stay away from people who are sick.
- Wash your hands regularly with soap and water or use an alcohol-based hand sanitiser. This is really important after coughing, sneezing or touching shared surfaces.
- Cover your nose and mouth with a tissue when you cough or sneeze or use the inside of your elbow. Throw away used tissues straight away in the bin.
- Don’t touch your eyes, nose or mouth with unwashed hands.
- Wear a mask in crowded places.
- Don’t share cups, glasses or cutlery with people who are unwell.
Talk to your GP or rheumatologist about whether you should pause any of your arthritis medicines if you become sick with a chest or airways illness.
COVID-19
Most people with COVID-19 have mild symptoms, and don’t need medical help. Some people have no symptoms at all. However, people with arthritis have an increased chance of being more unwell – especially if you are on certain medicines.
Symptoms
Common symptoms of COVID-19 include:
- Fever or chills
- Cough
- Sore throat or runny nose
- Shortness of breath
- Fatigue (feeling very tired)
- Headache or muscle aches
- Loss of taste or smell
- Nausea, vomiting or diarrhoea.
What to do if you test positive
If you test positive on a rapid antigen test (RAT) or PCR test, get in touch with your GP as soon as possible – especially if you are over 70 or on an immune suppressing treatment. There are special treatments for COVID-19 and these work best when started early. Your GP will tell you if a treatment is right for you, based on your age, health and the other medicines you take.
If you test positive for COVID-19, get in touch with your GP quickly. Treatments are at hand but starting early gives you the best results.
Influenza (Flu)
Influenza – commonly called the flu – can easily spread from one person to another. It is more serious than a common cold and, in some cases, can lead to pneumonia. Flu is most common in autumn and winter, but it can happen at any time of year.
Symptoms
Flu symptoms tend to come on suddenly and can last more than a week.
- Fever and chills
- Cough, sore throat and runny or stuffy nose
- Muscle aches, joint pain and headaches
- Fatigue (feeling very tired)
- Nausea, vomiting or diarrhoea (more common in children).
If you think you have the flu, get in touch with your GP. Medicines are available for flu and work best when started within 48 hours of symptoms beginning.
Other Respiratory Viruses
You may have heard about other respiratory viruses cause illnesses that affect the chest and airways. They have complicated names, for example RSV (respiratory syncytial virus), pneumococcal disease, rhinovirus and human parainfluenza viruses. For most people these cause mild, cold-like symptoms and will pass on their own. However, people who are older, have a weaker immune system, have chronic lung or heart conditions, or are pregnant may be at higher risk of more serious illness.
Vaccination
Vaccination is one of the best ways to protect yourself from serious chest and airways illness. We strongly suggest that you talk about both COVID-19 and flu vaccinations (shots) with your GP or rheumatologist.
COVID-19 vaccination
- COVID-19 vaccines lower the chance of serious illness. Even if you do get COVID-19 after vaccination, you will likely be less sick.
- Vaccine recommendations are published in the Australian Immunisation Handbook. This includes which vaccines are available and how often you should have them. COVID-19 | The Australian Immunisation Handbook
- If you take certain medicines for arthritis that suppress the immune system your vaccine response may not be as strong as in other people. This is another reason why vaccination is important, not a reason to delay it.
- Do not stop your arthritis medicines before or after vaccination without talking to your GP or rheumatologist first. Stopping suddenly can cause a flare.
- If you have had COVID-19, you should still be vaccinated. Vaccination provides additional protection against future infection.
- Your GP can advise how often you should have a COVID-19 vaccination based on your age and health.
- You can have the flu vaccine and the COVID-19 vaccine at the same time. Having the COVID-19 vaccine does not protect you from flu.
Flu vaccination
- A flu vaccine is recommended every year for people living with arthritis.
- The flu vaccine will not give you the flu. It lowers the chance of you being really sick if you do get the flu.
- Anyone aged six months and over can be vaccinated against flu. Ask your GP, pharmacist or rheumatologist about what is right for you.
- It is a good idea to get everyone living at your home to get the shot too. This helps protect you if your body’s defences are reduced.
RSV vaccination
The following people are eligible for RSV vaccination funded by the National Immunisation Program (NIP):
- pregnant women from 28 weeks gestation
- Aboriginal and/or Torres Strait Islander adults aged 60 years and over
- adults aged 75 years and over.
Young infants whose mothers did not receive RSV vaccine in pregnancy and children who are at increased risk of severe RSV disease are also recommended to have an RSV vaccination.
If you are over 50 years and on a medicine that suppresses your immune system (for example biologic medicines for rheumatoid arthritis like adalimumab and infliximab, and oral corticosteroids) then it is recommended by the Australian Immunisation Handbook that you have the RSV vaccine, although it is not currently funded by the NIP. Ask your GP, pharmacist or rheumatologist about whether you are eligible.
Pneumococcal vaccine
The following people are eligible for pneumococcal vaccination funded by the National Immunisation Program (NIP):
- routine vaccination in infants and children at 2, 4 and 12 months of age
- Aboriginal and Torres Strait Islander adults aged 50 years and over
- adults aged 70 years and over.
The Australian Immunisation Handbook recommends pneumococcal vaccination for children, adolescents and adults with risk conditions for pneumococcal disease – this includes being on a medicine that suppresses your immune system (for example biologic medicines for rheumatoid arthritis like adalimumab and infliximab, and oral corticosteroids). However, this is not currently funded by the NIP. Ask your GP, pharmacist or rheumatologist about whether you are eligible.
Managing a Chest or Airways Illness at Home
If you do get COVID-19 or the flu, here are some tips to help you recover.
- Rest as much as possible.
- Stay well hydrated – drink water regularly. If you have vomiting or diarrhoea, an electrolyte replacement drink can help.
- Paracetamol can help reduce fever, aches and sore throat. Always follow the instructions on the packet.
- Ibuprofen is not right for everyone. Pregnant women and people on certain medicines should avoid it. Speak to your pharmacist or GP if you are not sure.
- Antibiotics do not treat viral infections like COVID-19 and flu. There are some antiviral treatments which your GP can prescribe if they are right for you.
- Talk to your GP or rheumatologist about whether you should pause any of your arthritis medicines while you are unwell.
When to Seek Help
Contact your GP if:
- You test positive for COVID-19 – treatments may be available and are best when started quickly, especially if you are over 70 or on an immune suppressing treatment.
- You think you may have the flu, especially if you are at higher risk of serious illness
- Your symptoms are getting worse or are not improving after a few days
- You are not sure what to do about your arthritis medicines
- You have any concerns about your health.
Call 000 or go to your nearest emergency department if you have:
- Difficulty breathing or shortness of breath
- Chest pain or pressure
- Confusion or change in consciousness
- Bluish lips or face.
You can also call Healthdirect 24 hours a day, 7 days a week on 1800 022 222
for free health information and advice
Useful Resources
Vaccine recommendations are updated regularly. Always check the Australian Government website for the most current advice. This information was last reviewed May 2026. If you have questions about your personal situation, speak to your GP or rheumatologist.