The potential infectious over-risk COVID-19 of immunosuppressive treatments, including biologic disease-modifying antirheumaric drugs (bDMARDS) and targetic synthetic disease- modifying antirheumaric drugs (tsDMARDS) needs to be considered for the patient population that are candidates for spa treatment. The French High Public Health Committee has included treatment with “biotherapy and / or suppressive dose corticosteroid therapy” among the risks of severe or serious of COVID-19 infection form. We have reviewed studies published up to the end of June 2020 concerning the excess risk of COVID-19 infection in patients treated with bDMARDs, tsDMARDs, other immunosuppressants and / or corticosteroid therapy. With a current low to intermediate level of evidence (observational, prospective or retrospective studies, sometimes with comparison to the general population, studies carried out from the registry) the increased risk of COVID-19 infection in patients treated with bDMARDs or tsDMARDs appears to be null or moderate. An increased risk of severe COVID-19 infection (transfer to intensive care unit or death) has not been demonstrated. The increased risk of infec- tion COVID-19 seems mainly linked to associated comorbidities and corticosteroid therapy. The infectious excess risk of methotrexate remains to be determined. If the scientific data published to date does not allow us to conclude today that there is a proven increased risk of non-serious or serious COVID-19 infection in patients treated bDMARDs or tsDMARDs we nevertheless believe that caution should continue to be required for this population when prescribing and monitoring a spa treatment.