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Abstract Number: 076

COVID-Distress in Children with Systemic Lupus Erythematosus During the COVID-19 Pandemic

Brooke Rezmer1, Michelle Adler2, Tamar Rubinstein3, Andrea Knight4 and Natoshia Cunningham5, 1Michigan State University College of Human Medicine, Grand Rapids, MI, 2Michigan State University, East Lansing, 3Children's Hospital at Montefiore, New York, NY, 4The Hospital for Sick Children, Toronto, ON, Canada, 5Michigan State University, Grand Rapids, MI

Meeting: 2023 Pediatric Rheumatology Symposium

Keywords: Anxiety, COVID-19, Disease Activity, mental health, Systemic lupus erythematosus (SLE)

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Session Information

Date: Thursday, March 30, 2023

Title: Posters: Clinical and Therapeutic I

Session Type: Poster Session A

Session Time: 6:00PM-7:00PM

Background/Purpose: Psychological symptoms are common in childhood-onset systemic lupus erythematosus (cSLE) and may impact other psychological and health-related outcomes. Mental health problems such as anxiety have increased throughout the COVID-19 pandemic and may be correlated to pandemic-related distress. The current study examines COVID-related distress in youth with cSLE, the relationship between anxiety and COVID-distress, and whether COVID-distress is associated with other aspects of mental health and health-related functioning when controlling for patient-reported anxiety symptoms.

Methods: Fifty-nine participants between the ages of 12 and 22, diagnosed with cSLE per American College of Rheumatology Classification Criteria, were recruited from August 2020-November 2022 across seven pediatric rheumatology clinics in the United States and Canada as part of a larger psychological treatment study. Youth completed a baseline assessment and reported COVID-related distress on a visual analog scale with scores ranging from 0 indicating “no distress” to 100 indicating “extreme distress.” Several mental health and health-related factors were also measured via validated questionnaires: anxiety (Screen for Child Anxiety Related Disorders, [SCARED]), depressive symptoms (Childrens Depression Inventory 2, [CDI-2] or Beck Depression Inventory II, [BDI-II]), disease activity (SLE Disease Activity Index, [SLEDAI]), pain (0-10 numeric rating scale), and fatigue (Pediatric Fatigue Short Form or Adult Short Form, [PROMIS]). Descriptive data and bivariate correlations were conducted. COVID-distress was compared based on sociodemographic factors including race, ethnicity, and income. Then, separate multiple regressions were conducted to examine the impact of COVID-related distress in predicting depression, fatigue, disease activity, and pain when accounting for patient-reported anxiety.

Results: The average age of participants was 16.34 years (SD = 1.99), 94.9% of which were female. Participants reported an average CDI of 63.54 (SD = 9.68), BDI of 62.19 (SD = 12.46), and SCARED of 33.64 (SD = 14.94) with a mean SLEDAI of 4.43 (SD = 5.15; median = 2.00). Participants reported moderate levels of COVID-related distress (Mean = 51.58, SD = 23.30), which was correlated with anxiety (r = 0.35, p < 0.05) and depressive symptoms (r = 0.28, p < 0.05), but not other study variables. COVID-distress rates were comparable between race, ethnicity, and income groups. When examining the simultaneous impact of both COVID-related distress and anxiety on outcomes via multiple regression analyses, the overall models were significant for depressive symptoms, F (2, 36) = 4.84, p < 0.05, and fatigue, F (2, 36) = 5.26, p < 0.05, but not for pain nor disease activity. Further, only anxiety (and not COVID-distress) significantly predicted depressive symptoms (beta = 0.45, p < 0.01) and fatigue (beta = 0.49, p < 0.01).

Conclusion: Findings suggests moderate levels of COVID-related distress in cSLE patients, which was correlated with other aspects of mental health functioning. Interestingly, anxiety and not COVID-distress was a more robust predictor of depression and fatigue in cSLE.


Disclosures: B. Rezmer: None; M. Adler: None; T. Rubinstein: None; A. Knight: None; N. Cunningham: None.

To cite this abstract in AMA style:

Rezmer B, Adler M, Rubinstein T, Knight A, Cunningham N. COVID-Distress in Children with Systemic Lupus Erythematosus During the COVID-19 Pandemic [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 4). https://acrabstracts.org/abstract/covid-distress-in-children-with-systemic-lupus-erythematosus-during-the-covid-19-pandemic/. Accessed .
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