Impact of COVID-19 pandemic on patients with rheumatic diseases in Latin America

Fernández-Ávila, Daniel G.; Barahona-Correa, Julián E.; Romero-Alvernia, Diana; Kowalski, Sérgio Cândido; Sapag, Ana; Cachafeiro-Vilar, Antonio; Meléndez, Belia; Pastelín, C. S.; Palleiro, Daniel; Arrieta, Dina; Reyes, Gil; Pons‐Estel, Guillermo J.; Then-Báez, Jossiell; Ugarte‐Gil, Manuel F.; Cardiel, Mario H.; Colman, Nelly; Chávez, Nilmo; Burgos, Paula I.; Montúfar, Rubén; Sandino, Sayonara; Fuentes-Silva, Yurilís; Soriano, Enrique R.

doi:10.1007/s00296-021-05014-y

Cited by 23 publications

(31 citation statements)

References 32 publications

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“…13 Another study performed in Latin America revealed that patients with inflammatory rheumatic diseases were negatively affected by the COVID-19 pandemic, characterized by an increase in self-rated disease activity, a reduction in medication adherence, and hurdles to medical follow-up. 14 To ensure continuous care of these patients, teleconsultation may represent a valid alternative to in-person visits during the pandemic. During the early days of the pandemic, DMARD interruptions were associated with an absence of telemedicine availability.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Patients With Rheumatoid Arthritis in Teleconsultation During the First Wave of the COVID-19 Pandemic

et al. 2022

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Objective To describe which parameters were collected by rheumatologists to monitor patients with rheumatoid arthritis (RA) during teleconsultation and identify which ones have more impact on clinician intervention. Methods Retrospective monocentric routine care cross-sectional study including RA patients seen in teleconsultation between March and September 2020. Available parameters assessing disease status were collected in teleconsultation files. Clinician intervention was defined by treatment escalation and/or the need for a rapid face-to-face consultation or day hospitalization. Results 143 RA patients were included (117 females, mean age of 58±16 years, mean disease duration of 14±11 years). The presence or absence of patient self-reported RA flares was mentioned in all medical files, followed by the presence and/or the number of tender joints (76%), the duration of morning stiffness (66%), the number of pain-related nocturnal awakenings (66%) and the CRP value (54%). Teleconsultation led to a clinician intervention in 22/143 patients (14%), representing 51% of patients with self-reported flares (22/43 patients). Therapeutic escalation was necessary in 13 patients and/or face-to-face consultation or day hospitalization were organized for 10 patients. Multivariate analysis identified RA flares (Odds Ratio, OR: 15.6 95% CI 3.37-68.28) and CRP values >10 mg/L (OR: 3.32, 95% CI % 1.12-13.27) as the variables independently associated with clinician intervention. Conclusion Our study identified patient reported RA flares and increased CRP values as 2 red flags in teleconsultation, independently associated with therapeutic modification and/or the need for a rapid face-to-face consultation. These indicators may help clinician's decision making in teleconsultation.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Patients With Rheumatoid Arthritis in Teleconsultation During the First Wave of the COVID-19 Pandemic

et al. 2022

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“…One of the most common comorbidities in severe COVID-19 patients is hypertension, which is also a risk factor for pneumonia and severe disease in the general population and patients with multiple comorbidities, including rheumatic diseases [ 20 , 62 – 64 ]. Therefore, blood pressure follow-up during the lockdown was an important point for public health services.…”

Section: Comorbidities During the Covid-19 Pandemicmentioning

confidence: 99%

“…From RA patients, 280 were at risk of anxiety and 227 of depression; from SLE patients, 56 were at risk of anxiety, and 50 were at risk of depression. [ 17 ] Ireland RMDs and COVID-19 from database C19-GRA 212 625.5% ever smoked 71.7% were hospitalized ( p =0.01), and 20.4% died ( p =0.02) [ 18 ] Brazilian teaching hospitals (Ceará, Minas Gerais, and Rio Grande do Sul) Patients over 18 years of both sexes diagnosed with RA 791 15% had DM II, 9.2% had SAH, 34.3% had dyslipidemia, and 26.9% had obesity by BMI RA patients with increased WC have more CVR factors (such as DM II (31.2%), SAH (80.2%), and dyslipidemia (50.0%)) and these variables have an independent influence on the prevalence of obesity [ 19 ] Latin America, 2021 Rheumatologic patients during lockdown 3502 (1694 with RA and 1012 with SLE) Hypertension, depression, and anxiety The most common self-reported comorbidities were hypertension (669 patients; 19.1%) and depression/anxiety (455; 13.3%) [ 20 ] France (including French overseas territories) SLE patients recruited by their specialist or from AFL + 536 questionnaires from individual SLE patients Not mentioned Screening for anxiety and depression was positive for 47.6% and 41.5%, respectively. Difficulties accessing medical care were the only significantly associated factor to anxiety (OR = 1.94, p = 0.012).…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular health worsening in patients with autoimmune rheumatological diseases during the COVID-19 pandemic

et al. 2023

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Rheumatic autoimmune diseases are associated with a myriad of comorbidities. Of particular importance due to their morbimortality are cardiovascular diseases. COVID-19 greatly impacted the world population in many different areas. Patients with rheumatic diseases had to face changes in their healthcare, in addition to unemployment, a decrease in physical activity, social isolation, and lack of access to certain medications. This review summarizes the impact of COVID-19 pandemic on cardiovascular risk factors, comorbidities, and unhealthy behaviors in patients with rheumatic inflammatory autoimmune diseases, particularly focused on rheumatoid arthritis and systemic lupus erythematosus. Searches were carried out in MEDLINE/PubMed and Scopus from August to December 2022. Four reviewers screened the title and abstract of retrieved records. Potentially eligible reports were then reviewed in full text. Differences were reconciled by either consensus or discussion with an external reviewer. During the COVID-19 pandemic, patients with rheumatic diseases showed an increase in the prevalence of mental health disorders (43.2–57.7%), reduced physical activity (56.8%), and a worsening in eating behaviors. Alcohol intake increased (18.2%), especially in early phases of the pandemic. Smoking prevalence decreased (28.2%). Dyslipidemia and hypertension showed no changes. The pandemic and lockdown affected rheumatic patients not only in disease-related characteristics but in the prevalence of their cardiovascular comorbidities and risk factors. Lifestyle changes, such as healthy eating, physical activity, and optimal management of their rheumatic diseases and comorbidities, are essential to manage the long-lasting consequences of the COVID-19 outbreak. Key Points • During the COVID-19 pandemic, anxiety, depression, sedentarism, obesity, and a worsening in eating behaviors increased. •Patients with rheumatic diseases and comorbidities have worse clinical outcomes and a higher cardiovascular disease burden than those without them. •Comparative studies are necessary to precisely elucidate the pandemic’s impact on the prevalence of cardiovascular disease, risk factors, and comorbidities in patients with rheumatoid arthritis and systemic lupus erythematosus.

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“…La pandemia por la COVID-19 tuvo un efecto negativo en el control de la enfermedad reumática y en su manejo. Un estudio observacional llevado a cabo por el grupo de la Liga Panamericana de Asociaciones de Reumatología (Panlar, por sus siglas en inglés) en 19 países latinoamericanos, identificó que la situación de la pandemia llevo a la interrupción de al menos un medicamento modificador de la enfermedad en el 23,4%, y las razones más frecuentemente relacionadas con la interrupción fueron el miedo al contacto con el virus o problemas económicos, con autorreportes de incremento de la actividad de la enfermedad 7 . Con posterioridad, luego del inicio de la vacunación y la priorización de los pacientes con enfermedades reumatológicas, se consiguió una recuperación gradual de la normalidad en el diario vivir, sin embargo, había incertidumbre con respecto a las recaídas o los eventos adversos relacionados con un nuevo tipo de vacunas.…”

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COVID 19 - Algunas lecciones y muchas más por aprender

Díaz

Calixto

2022

Revista Colombiana de Reumatología

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Impact of COVID-19 pandemic on patients with rheumatic diseases in Latin America

Cited by 23 publications

References 32 publications

Evaluation of Patients With Rheumatoid Arthritis in Teleconsultation During the First Wave of the COVID-19 Pandemic

Evaluation of Patients With Rheumatoid Arthritis in Teleconsultation During the First Wave of the COVID-19 Pandemic

Cardiovascular health worsening in patients with autoimmune rheumatological diseases during the COVID-19 pandemic

COVID 19 - Algunas lecciones y muchas más por aprender

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