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Epidemiology
Impact of the COVID-19 pandemic on the disease course of patients with inflammatory rheumatic diseases: results from the Swiss Clinical Quality Management cohort
  1. Adrian Ciurea1,
  2. Eleftherios Papagiannoulis2,
  3. Kristina Bürki1,
  4. Isabell von Loga2,
  5. Raphael Micheroli1,
  6. Burkhard Möller3,
  7. Andrea Rubbert-Roth4,
  8. Michael Andor5,
  9. René Bräm6,
  10. Angela Müller7,
  11. Diana Dan8,
  12. Diego Kyburz9,
  13. Oliver Distler1,
  14. Almut Scherer2,
  15. Axel Finckh10
  1. 1 Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
  2. 2 SCQM Foundation, Zurich, Switzerland
  3. 3 Department of Rheumatology, Clinical Immunology and Allergy, Inselspital University Hospital Bern, Bern, Switzerland
  4. 4 Division of Rheumatology, Kantonsspital Sankt Gallen, Sankt Gallen, Switzerland
  5. 5 Private Rheumatology Practice, Uster, Switzerland
  6. 6 Swiss Ankylosing Spondylitis Association, Zurich, Switzerland
  7. 7 Rheumaliga Schweiz, Zurich, Switzerland
  8. 8 Department of Rheumatology, CHUV, Lausanne, Switzerland
  9. 9 Department of Rheumatology, University Hospital Basel, Basel, Switzerland
  10. 10 Department of Rheumatology, Geneva University Hospitals, Geneve, Switzerland
  1. Correspondence to Professor Adrian Ciurea, Department of Rheumatology, University Hospital Zurich, Zurich 8091, Switzerland; adrian.ciurea{at}usz.ch

Abstract

Objectives To 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).

Methods Patient-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.

Results The 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.

Conclusion A 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.

  • arthritis
  • rheumatoid
  • spondylitis
  • ankylosing
  • arthritis
  • psoriatic
  • epidemiology

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/annrheumdis-2020-218705

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    Footnotes

    • Handling editor Josef S Smolen

    • AS and AF contributed equally.

    • Contributors Study conception and design: AC, AF, AM, AR-R, AS, BM, DD, DK, EP, IvL, OD, RB. Acquisition of data: AC, KB, RM, BM, AR-R, MA, DD, DK, OD and AF. Statistical analysis: EP and AS. All authors contributed to the interpretation of the data. AC wrote the manuscript. All authors critically revised the manuscript. All authors revised and approved the final manuscript to be published.

    • Funding The SCQM Foundation is supported by the Swiss Society of Rheumatology and by AbbVie, Amgen, Gilead, iQone, Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Samsung Bioepis, Sandoz, Sanofi Genzyme, UCB.

    • Competing interests AC reports personal fees from Abbvie, Celgene, Eli-Lilly, Merck Sharp & Dohme, Novartis and Pfizer, outside the submitted work. OD reports personal fees from Abbvie, Amgen, Lilly and Pfizer, outside the submitted work. RM reports personal fees from Gilead, Eli-Lilly and Abbvie, outside the submitted work.

    • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

    • Patient consent for publication Not required.

    • Ethics approval The study was approved by the Ethics Committee of the Canton of Geneva and written informed consent was obtained from all patients.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.