COVID-19-linked changes reported in rheumatic disease patient care

(HealthDay)—Changes to health care have been reported among patients with rheumatic diseases during the COVID-19 pandemic, according to a study published online April 20 in ACR: Open Rheumatology.

Kaleb Michaud, Ph.D., from the University of Nebraska Medical Center in Omaha, and colleagues examined the impact of the COVID-19 pandemic on patients with rheumatic diseases. Participants were surveyed on March 25, 2020, about their symptoms, COVID-19 testing, health care changes, and related experience in the previous two weeks. Data were included from 530 patients, 61 percent of whom had rheumatoid arthritis.

The researchers found that 11 patients met the screening criteria for COVID-19, and two of them sought testing unsuccessfully. Six others who did not meet screening criteria sought testing and three were successful; all were negative for COVID-19. Forty-two percent of the patients reported a change to their care in the previous two weeks. These patients reported canceled or postponed appointments (48 percent), a switch to teleconference appointments (24 percent), self-imposed (14 percent) or physician-directed (11 percent) changes to their medication list or dose, an inability to obtain medication (10 percent), and inability to reach their rheumatology office (4 percent). Four key themes were revealed in a qualitative analysis: emotions in response to the pandemic, perceptions of immunosuppressive medication-related risks, protective measures to reduce COVID-19 infection risk, and disruption in accessing rheumatic disease medications, including hydroxychloroquine.

"We found that after two weeks many participants in the United States with rheumatic diseases already had important changes to their health care, including canceling appointments, which was independently linked to increased disease activity, and altering medications without professional consultation or due to hydroxychloroquine shortage," the authors write. "There were important impacts on mental health and continued uncertainty on how best to treat these diseases and stay protected from COVID-19."

Several authors disclosed financial ties to pharmaceutical companies, including Novartis, which is a manufacturer of hydroxychloroquine.

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