Effects of the COVID‐19 Pandemic on Patients Living With Vasculitis

Abstract

Objective This study aimed to analyze the concerns and health‐related behaviors in patients with vasculitis during the early phase of the coronavirus disease 2019 (COVID‐19) pandemic in North America. Methods Patients with vasculitis in North America were invited to complete an online survey through the Vasculitis Patient‐Powered Research Network in collaboration with the Vasculitis Foundation and the Relapsing Polychondritis Foundation. Questions focused on concerns and behaviors related to doctors’ visits, tests, medication, and telehealth use. Factors affecting their concern and health‐related behaviors were determined. Results Data from 662 patients were included: 90% of patients were White, 78% were women, 83% expressed moderate or high levels of concern about COVID‐19, and 87% reported that their vasculitis moderately or extremely affected their level of concern. Older age, female sex, lung disease, and immunosuppression were associated with greater concern. Doctors’ visits, laboratory tests, and other tests were avoided by 66%, 46%, and 40% of patients, respectively. Younger age, urban location, higher income, higher concern levels, and prednisone use (>10 mg/day) were associated with greater likelihood of avoiding visits or tests. Ten percent of patients on immunosuppressive therapy stopped their medication. Twenty‐nine percent patients on rituximab avoided an infusion. Forty‐four percent of patients had telehealth visits; more visits were reported for younger patients, for patients on glucocorticoids, and in Canada versus the United States. Conclusion During the COVID‐19 pandemic, patients with vasculitis have high levels of concern and exhibit potentially harmful health‐related behaviors. Health care use varies across different demographic groups and geographic regions. Specific strategies are warranted to facilitate engagement of these patients with the health care system during the pandemic.

Social Distancing, Health Care Disruptions, Telemedicine Use, and Treatment Interruption During the COVID‐19 Pandemic in Patients With or Without Autoimmune Rheumatic Disease

“…We found that 10% of patients receiving immunomodulatory medications had stopped one of their medications because of concerns about COVID‐19, even if they were well with no COVID‐19 diagnosis or respiratory illness. Most medication interruptions were not recommended by a physician, similar to results from previous studies (10–12,22,23). Guidance from the American College of Rheumatology recommends not stopping medications unless patients have contracted or been exposed to severe acute respiratory syndrome coronavirus 2, although this guidance was first published in April 2020 and was not available when many patients answered their surveys (24).…”

The COVID-19 pandemic and ANCA-associated vasculitis – reports from the EUVAS meeting and EUVAS education forum

“…Information on outcome (i.e. relapses) was not part of the survey [ 42 ]. The first wave of the pandemic had a significant impact on patient care.…”

Disruptions in Rheumatology Care and the Rise of Telehealth in Response to the COVID‐19 Pandemic in a Community Practice–Based Network

“…Telehealth use in rheumatology prior to the COVID-19 pandemic was primarily limited to treating patients in rural areas that were medically underserved (1,2). The COVID-19 pandemic, however, has led to substantial health care disruptions and a rapid rise in telehealth use among patients with rheumatic and musculoskeletal diseases (RMDs) (3)(4)(5)(6). Many of these patients are at increased risk of infection and may be at increased risk of severe COVID-19 due to immune dysregulation from their rheumatic condition, immunosuppressive medications, or multiple comorbid health conditions (i.e., multimorbidity) (7)(8)(9).…”