Impact of COVID-19 Pandemic Among Patients With RA

Many patients with rheumatic diseases reported changing their health care plan during the 2 weeks prior to March 25, 2020, with some making changes to their medication without consulting a physician, according to the findings of a recent study.

“Patients with rheumatic diseases such as rheumatoid arthritis (RA) and lupus have increased risk of infection and are treated with medications that may increase this risk yet are also hypothesized to help treat COVID-19,” the researchers said. They investigated the impact of the COVID-19 pandemic on the lives of patients with RA in the United States.

Among 7061 individuals enrolled in a US-wide longitudinal observational registry, 530 participants responded to a supplemental COVID-19 questionnaire, which was emailed to participants on March 25, 2020. RA was the most frequent diagnosis among respondents (61%).
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Using responses to questions on diagnosis, disease activity, new onset of symptoms, and statements left in free-text comment fields, the researchers analyzed symptoms, COVID-19 testing, health care changes, and related experiences during the 2-week study period. 

The researchers found 11 participants met COVID-19 screening criteria, and 2 reported that they sought testing unsuccessfully. Of 6 other participants who sought testing, 3 were successful and all tests were negative, they noted.

Overall, 42% of participants reported a change to their care in the 2-week study period, the researchers said.

In qualitative analysis, the researchers found 4 key themes: emotions in response to the pandemic; perceptions of risks from immunosuppressant medications; protective measures to reduce the risk of infection; and disruptions in accessing rheumatic disease medications, including hydroxychloroquine.

“After two weeks, many with rheumatic diseases already had important changes to their healthcare, with many altering medications without professional consultation or due to hydroxychloroquine shortage,” the researchers concluded.

“As evidence accumulates on the effectiveness of potential COVID-19 treatments, effort is needed to safeguard access to established treatments for rheumatic diseases,” they added.

Reference

Michaud K, Wipfler K, Shaw Y, et al. Experiences of patients with rheumatic diseases in the US during early days of the COVID-19 pandemic [published online April 20, 2020]. ACR Open Rheumatol. doi:10.1002/acr2.11148