Impact of the COVID-19 pandemic on the disease course of patients with inflammatory rheumatic diseases: results from the Swiss Clinical Quality Management cohort

Abstract

ObjectivesTo investigate whether the transient reduction in rheumatology services imposed by virus containment measures during the COVID-19 pandemic was associated with disease worsening in axial spondyloarthritis (axSpA), rheumatoid arthritis (RA) or psoriatic arthritis (PsA).MethodsPatient-reported disease activity assessed during face-to-face visits and/or via a smartphone application were compared between three periods of each 2 months duration (before, during and after the COVID-19-wave) from January to June 2020 in 666 patients with axSpA, RA and PsA in the Swiss Clinical Quality Management cohort.ResultsThe number of consultations dropped by 52%, whereas the number of remote assessments increased by 129%. The proportion of patients with drug non-compliance slightly increased during the pandemic, the difference reaching statistical significance in axSpA (19.9% vs 13.2% before the pandemic, p=0.003). The proportion of patients with disease flares remained stable (<15%). There was no increase in mean values of the Bath Ankylosing Disease Activity Index, the Rheumatoid Arthritis Disease Activity Index-5 and the Patient Global Assessment in patients with axSpA, RA and PsA, respectively.ConclusionA short interruption of in-person patient–rheumatologist interactions had no major detrimental impact on the disease course of axSpA, RA and PsA as assessed by patient-reported outcomes.

Effects of the COVID-19 pandemic on psychology and disease activity in patients with ankylosing spondylitis and rheumatoid arthritis

“…Whether the follow-up, treatment, and disease activity of rheumatological diseases changed during the pandemic has been the subject of many studies [46,47]. Lopez et al…”

“…Complaints such as depression, sleep disorders, loss of appetite, and fatigue, which are difficult to adapt to and make it harder to maintain social communication, can be seen more frequently in patients with chronic diseases [15]. Interestingly, the risk of COVID-19 was reported to not be higher in RA and AS patients with no effect on the clinical course of these diseases during the pandemic [16,17]. However, patients with rheumatological diseases, who are prone to psychological disorders, are likely to be easily psychologically affected by the COVID-19 outbreak.…”

Comorbidities in rheumatic diseases need special consideration during the COVID-19 pandemic

“…In data from Switzerland, there was no increase in disease activity of RMDs in the short term since the onset of the pandemic. However, drug non-compliance has increased [ 152 ]. This might lead to increased flares in the near future.…”

Correspondence on ‘Impact of the COVID-19 pandemic on the disease course of patients with inflammatory rheumatic diseases: results from the Swiss Clinical Quality Management cohort’

“…This could be explained by the fact that almost all our patients were on biological or targeted DMARDs, known to increase infectious risk. 1 3 4 Thus, despite this risk and the fear of COVID-19, 4 5 patients were also very adherent to their RA medications, and therapeutic changes were mainly driven by RA activity, as observed in the Swiss Registry by Ciurea et al 1 This could be explained by the adaptive effort of the medical community that struggle to keep the link with their isolated patients, with an increased use of teleconsultation and only a few planned medical visit cancelled during this period.…”

“…We read with a great interest the comment from Ciurea et al 1 recently published in Annals of Rheumatic Diseases about the impact of confinement measures lead by the COVID-19 pandemic on disease management of inflammatory rheumatic diseases.…”