You are here

Article Text

Article menu
Download PDFPDF
Letter
Challenges in the diagnosis of early rheumatoid arthritis in times of COVID-19
  1. Bernardo D'Onofrio1,2,
  2. Ludovico De Stefano1,2,
  3. Bianca Lucia Palermo1,2,
  4. Blerina Xoxi1,
  5. Antonio Manzo1,2,
  6. Carlomaurizio Montecucco1,2,
  7. Serena Bugatti1,2
  1. 1 Division of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
  2. 2 Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
  1. Correspondence to Professor Serena Bugatti, Division of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia 27100, Italy; serena.bugatti{at}unipv.it

https://doi.org/10.1136/annrheumdis-2021-220219

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Challenges in the provision of care and patients’ reluctance to access healthcare services and adhere to drug prescriptions in course of COVID-19 pandemic undermine the fundamental principles of early diagnosis and treat to target, which have revolutionised the natural history of many chronic inflammatory diseases starting from rheumatoid arthritis (RA).1 Although most rheumatologists have the impression that the intervals between symptom onset and first consultation have increased,2 no data currently indicate whether and to what extent the picture of early RA has changed during COVID-19.

    Here, we analysed data from the Pavia Early Arthritis Clinic (EAC) inception cohort. Referral criteria have been described previously, and include the presence of signs and symptoms of suspected inflammatory arthritis for <12 months of duration.3 By 31 December 2020, the EAC collects information on 2.508 patients. The service has undergone complete closure during the first wave of COVID-19 pandemic from 9 March to 18 May 2020. In this period, emergency visits were guaranteed through the general rheumatology outpatient clinic. For this study, baseline characteristics of patients referred in the semester following the lockdown (July to December 2020) were compared with: (1) patients referred in the semester immediately preceding the lockdown (July to December 2019); (2) patients referred in a semester of routine use of the 2010 RA criteria (July to December 2015); (3) patients referred in the semester following the dissemination of the 2010 RA criteria (July to December 2011); and (4) patients referred in the semester preceding the publication of the 2010 …

    View Full Text

    Footnotes

    • Handling editor Josef S Smolen

    • Contributors BDO contributed to the acquisition, analysis and interpretation of data and drafted the manuscript. LDS contributed to the analysis and interpretation of data. BLP and BX contributed to the acquisition of data. AM and CM contributed to the interpretation of data. SB conceived the work, contributed to the analysis and interpretation of data and drafted the manuscript. LDS, BLP, BX, AM and CM revised the manuscript critically for important intellectual content. All the authors provided final approval of the version to be published.

    • Funding This study was supported in part by fundings from the IRCCS Policlinico San Matteo Foundation, Pavia, Italy.

    • Competing interests None declared.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.