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

Gamze Kılıç1, Onur Kaan Gedikli1, Cemil Güner2

  • 1Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Karadeniz Technical University Faculty of Medicine Trabzon, Türkiye.

Journal of Clinical Practice and Research
|November 19, 2025
PubMed

Insights

The Coronavirus Disease 2019 (COVID-19) pandemic impacted inflammatory rheumatic diseases (IRD) patients, with many altering treatments without medical advice. Healthy controls experienced more psychological distress than IRD patients.

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.
Abstract

Keywords:
COVID-19mental healthrheumatic diseasesspondyloarthritis

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