Background/Purpose: Fibromyalgia is a chronic pain disorder, characterized by abnormal pain processing in the central nervous system. Acute or chronic stress may trigger or aggravate symptoms.  We aimed to evaluate the physical and mental health of fibromyalgia (FMS) patients during the COVID 19 outbreak, and to identify related protective and risk factors.

Methods: An online survey was published via social media dedicated to fibromyalgia patients (FMS associations) in May 2020, following two months of lockdown and social distancing due to the COVID 19 outbreak. The survey included questionnaires regarding demographic and socio-economic characteristics, access to medical services, anxiety, depression, life approach, coping strategies and perception of social support. Fibromyalgia severity was assessed using the widespread pain index (WPI) and symptoms severity scale (SSS), insomnia severity index (ISI) and patient global assessment

Results: A total of 262 fibromyalgia patients were recruited of which 233 (90% women, median age 46.1 years) completed the entire study questionnaire and thus were included in the analysis. During the lockdown, 43% of patients stopped contact with their treating physician and 98% were forced to discontinue complementary – alternative treatments. On the other hand, all patients undergoing psychotherapy continued online follow-up. Among the 41% of responders who had been treated with medical cannabis, 30% were forced to discontinue treatment due to logistic difficulties and this was associated with significantly higher scores of WPI/SSS compared with patients who continued cannabis treatment (p=0.024). Higher levels of anxiety and depression were significantly correlated with higher levels of pain, sleep disorders and subjective perception of deterioration (p=0.00). Higher scores of social support and positive life approach were correlated with less anxiety and depression (p< 0.01), lower levels of pain (p< 0.05) and less sleep disturbances (p< 0.01). Avoidant coping style such as denial and behavioral disengagement was strongly associated to higher levels of pain, sleep disturbances, anxiety, depression and subjective perception of worsening (p< 0.01).

Conclusion: The current study documented high levels of anxiety, depression, sleep disturbances and pain among fibromyalgia patients during the COVID-19 outbreak, with a large proportion of patients reporting a worsening of symptoms during this period. While general stress associated with the pandemic is an obvious possible culprit for this course, additional factors such as difficulty in accessing medical and complementary treatments, as well as specific medications such as medical cannabis, may play a central role. Protective factors such as social support and a positive life approach appear to be particularly important.

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/pain-in-the-time-of-corona-impact-of-covid-19-outbreak-on-fibromyalgia-patients/