Depression is a common co-morbidity among rheumatoid arthritis (RA) patients, which may translate into difficulty performing activities of daily living. COVID-19 is an unprecedented disaster that has disrupted lives worldwide and led to a rise in the incidence of mental health disorders. Given the widespread economic devastation due to COVID-19, many RA patients, already susceptible to mental illness, maybe at an increased risk of inaccessibility to medical care, accentuated stress, and consequent worsening of existent mental health disorders, or the onset of new mental health disorders such as anxiety, posttraumatic stress disorder, or depression. The objective of this review is to assess if there is an increased risk of mental health disorders in patients with RA during the COVID-19 pandemic. Telemedicine has bridged the transition to remote chronic care in the pandemic period, though certain accessibility and technological challenges are to be addressed. Decreased access to care amid lockdowns and a proposed triggering of disease activity in patients with autoimmune disorders may potentially herald a massive spike in incidence or flares of patients diagnosed with RA in the coming months. Such a deluge of cases may be potentially devastating to an overburdened healthcare system. Rheumatologists may need to prepare for this eventuality and explore techniques to provide adequate care during these challenging times. The authors found that there is a significant association between the adverse impact on the mental health of RA patients and the COVID-19 pandemic. However, more research is needed to highlight individual risk factors.

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Instagram allows for graphical and visual information exchange. This paper aims to explore the current landscape of rheumatology on Instagram and analyse the accounts available based on their objectives and level of engagement. The search term “#rheumatology” reveals 62 results, leaving 55 after careful exclusion. On grouping into “educational”, “broadcasting”, “support”, and a combination of all three, an analysis is carried out using the total number of posts, follower counts, number of caption characters (last 10 posts), likes per post (last 10 posts), archived stories, reels, IgTV (Instagram Television) videos, hashtags, and links in bio. The analysis reveals that 29 accounts (52.7%) disseminate educational content, 36 (65.4%) are run by organisations, and 22 (40.0%) are of an institute or clinic. Character counts (rho 0.44, p = 0.0006) and videos (likes for ten posts 149 vs. 54, p = 0.006) positively correlate with the number of likes, while hashtag use and post count have no statistical significance with likes. Reels and IgTV videos are infrequently used (18.18%, 3.6%). The rheumatology social media landscape is in its nascency and currently split into educational and broadcasting accounts with a significant overlap between the two. The positive correlation of character counts and videos and the negative correlation of hashtag use and post count with likes lay the case for quality content to improve engagement. Social media editors may ensure quality content for rheumatology education using Instagram. Key Points • The current landscape of Instagram use in rheumatology is limited and largely orientated towards educative content. • Likes on Instagram are positively correlated with caption character counts and videos. • Using currently underutilised tools like videos, engaging captions, and infographics may enhance the utility of Instagram in rheumatology education. Supplementary Information The online version contains supplementary material available at 10.1007/s10067-021-05947-6.

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