Significant impact of the COVID-19 pandemic on the physical and mental health of patients with inflammatory rheumatoid arthritis

According to a study published in the recent issue of Clinical Rheumatology, 40% of the subjects with an inflammatory rheumatic disease (IRDs) report negative physical and mental effects related to the COVID-19 pandemic. 

Dr. Hider and his team conducted a cross-sectional survey to investigate the impact of COVID-19 on the physical and mental health of patients with IRDs. A total of 638 individuals completed the survey, with 250 and 241 reporting moderate/severe impacts of the COVID-19 pandemic on their physical and mental health, respectively. The results indicated that women reported more negative effects of the pandemic on their physical (44% vs. 34%) and mental health (44% vs. 34%), symptoms of arthritis (49% vs. 36%), and lifestyle factors (weight gain and decreased physical activity) compared to men. Experts noted that individuals with rheumatoid arthritis experienced less physical and psychological harm than those with other IRDs. However, no significant differences were observed between age groups regarding the impact on physical health, while younger patients reported stronger effects on mental health.

A 2022 longitudinal analysis has also reported the impact of COVID-related psychological stress on patients with rheumatic diseases. The study utilized the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS) to measure patient outcomes, and the results indicated that patients who reported stress at enrollment had improved PROMIS scores during follow-up, particularly for the anxiety subscale. Patients also reported ongoing and fresh stressors and described a variety of self-described coping mechanisms during the follow-up period. Ordinal logistic regression was performed to determine the factors associated with poorer enrollment-to-follow-up. The results showed that poorer enrollment-to-follow-up was associated with worse overall coping (odds ratio [OR], 4.4; p = 0.03), not reporting excellent/very good disease status at follow-up (OR, 2.7; p = 0.03), persistent stress caused by the pandemic (OR, 5.7; p = 0.007), adverse long-lasting effects caused by the pandemic (OR, 6.1; p = 0.003), and poor health (OR, 3.0; p = 0.05).

Significant improvement in physical and emotional functions has been noted with weaning off the pandemic, particularly in patients who had reported higher levels of stress at enrollment. It is important for rheumatologists to recognize and support the coping mechanisms that patients have identified for themselves and to assist patients in maintaining lifestyle modifications that may have contributed to their improved outcomes.

References 

  1. Hider S, Muller S, Gray L, Manning F, Brooks M, Heining D, Menon A, Packham J, Roddy E, Ryan S, Scott IC. Exploring the longer-term impact of the COVID-19 pandemic on physical and mental health of people with inflammatory rheumatic diseases: a cross-sectional survey. Clinical Rheumatology. 2023 Mar 7:1-7. 
  2. Duculan R, Jannat-Khah D, Wang XA, Mancuso CA. Psychological Stress Reported at the Start of the COVID-19 Pandemic and Subsequent Stress and Successful Coping in Patients With Rheumatic Diseases: A Longitudinal Analysis. Journal of Clinical Rheumatology. 2022 Aug;28(5):250. 

 

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