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

Abstract

Objective: The objective of this study was to investigate the impact of the Coronavirus Disease 2019 (COVID-19) on inflammatory rheumatic diseases (IRD) by comparing them with non-IRD (nIRD) and healthy controls (HC). Materials and Methods: In this cross-sectional study, subjects were screened for contact with COVID-19, new-onset symptoms, and adherence to precautionary measures against COVID-19. The Impact of Event Scale-Revised (IES-R) and Depression Anxiety and Stress Scales (DASS-21) were used to evaluate the psychological effect of the pandemic and health status. Additionally, therapy adherence and clinical characteristics were noted. Results: A total of 279 subjects were recruited (IRD 47.3%; nIRD 29.7%). The number of patients who believed that the risk of COVID-19 increased due to their diseases or received therapy was higher in IRD than nIRD (38.6% vs 7.2%). Maintaining physical distancing was highest in the IRD and lowest in HC (p=0.037). Approximately 40% of the patients discontinued or extended the dose interval of Tumor Necrosis Factor Inhibitor (TNFi) without obtaining physician’s advice. DASS-21 anxiety, depression and stress rates were lowest in IRD. COVID-19 contact history was an independent risk factor for DASS-21 stress and anxiety, while female gender was an independent risk factor for DASS-21 anxiety. Conclusion: Confirmed COVID-19 infection was similar in HC, IRD, and nIRD. HC were substantially more likely to experience mental health issues than other groups. Most patients with IRD discontinued or extended the ongoing treatment without physician’s recommendation during the COVID-19 outbreak. Therefore, patient adherence and disease control could be improved through closer monitoring and recognition of early signs of psychological discomfort during the COVID-19 pandemic.