The Impact of the COVID-19 Pandemic on Inflammatory Rheumatic Diseases

Area of Science:

• Rheumatology
• Infectious Diseases
• Psychiatry

Background:

• The COVID-19 pandemic presented unique challenges for patients with inflammatory rheumatic diseases (IRD).
• Understanding the pandemic's impact on IRD patients compared to non-IRD (nIRD) and healthy controls (HC) is crucial for patient management.
• Assessing psychological distress and treatment adherence during the pandemic is vital for maintaining disease control.

Purpose of the Study:

• To investigate the impact of COVID-19 on patients with inflammatory rheumatic diseases (IRD).
• To compare psychological effects and health status between IRD, nIRD, and HC groups during the COVID-19 pandemic.
• To evaluate treatment adherence and clinical characteristics in IRD patients during the pandemic.

Main Methods:

• A cross-sectional study involving 279 subjects (47.3% IRD).
• Screening for COVID-19 contact, symptoms, and precautionary measures.
• Utilized Impact of Event Scale-Revised (IES-R) and Depression Anxiety and Stress Scales (DASS-21) for psychological assessment.
• Recorded therapy adherence and clinical characteristics.

Main Results:

• Confirmed COVID-19 infection rates were similar across IRD, nIRD, and HC groups.
• Patients with IRD were more likely to perceive increased COVID-19 risk due to their condition or therapy (38.6% vs 7.2%).
• Approximately 40% of IRD patients altered Tumor Necrosis Factor Inhibitor (TNFi) dosage without physician consultation.
• DASS-21 scores for anxiety, depression, and stress were lowest in the IRD group.
• COVID-19 contact history and female gender were independent risk factors for DASS-21 anxiety and stress.

Conclusions:

• Healthy controls reported significantly higher levels of mental health issues compared to IRD and nIRD groups.
• A substantial number of IRD patients discontinued or modified their treatment regimens without medical guidance during the pandemic.
• Enhanced patient monitoring and early identification of psychological distress are recommended to improve adherence and disease control in IRD patients during health crises.