Background/Purpose: Research shows people with rheumatic conditions may be more susceptible to severe illness from COVID-19 due to their immunocompromised state. The COVID-19 pandemic has been associated with negative impacts on mental health (MH) & there is higher prevalence of depression & anxiety in patients with rheumatic illness. Most studies have focused on the medical impact of COVID-19; however, less is known about the MH impacts in this population. This needs assessment explores the psychosocial impact & needs of rheumatic disease patients during the pandemic.

Methods: A 95-item online survey in English & Spanish with Likert scale & open-ended questions was disseminated nationally from July-Oct. 2020 to rheumatic disease patients age 18+, promoted in NYC hospitals, local/national support programs & social media. The survey assessed physical & mental health, illness management, access to care, social environment & resources. The Patient Health Questionnaire-4 (PHQ-4) & the Hospital Anxiety & Depression Scale (HADS) assessed MH. A comparative analysis was conducted for those who reported a change in emotional health (ECs) vs. those who did not (NECs). Independent samples t-tests & chi-square tests were used to examine differences.

Results: Of the 382 responses received, most were age 35+ (79%), female (91%) & Non-Hispanic (77%). Almost half (46%) were White, 9% Asian, 8% African American & 6% Other. Almost all (96%) had health insurance; 50% were employed.

Most participants had SLE (67%), RA (19%), & Sjogren’s syndrome (8%) with a mean of 13 years since diagnosis. Over half (63%) reported a flare since the pandemic & 16% had COVID-19. Only 19% reported no changes to their care during the pandemic; 33% indicated their care switched to telehealth visits or appointments were postponed (19%).

Most (76%) reported a change in their mood and/or emotional health, with 81% indicating that this change was due to the pandemic. The mean PHQ-4 score for all respondents was 4.3 (SD: 3.5) with 31% scoring moderate/severe for psychological distress. The mean HADS Anxiety & HADS Depression scores were 8.2 (SD: 4.9) & 7 (SD: 4.3) with 54% & 43% scoring borderline/abnormal. Most (82%) shared they “feel isolated from others.”

Patients who experienced a negative emotional change (ECs) had significantly higher PHQ-4 & HADS scores (P< 0.001) than those who did not (NECs). Significant differences were found across these areas: ↑ % switching to telehealth (45% v 23%, P=0.001), receiving MH services (31% v 7%, P< 0.001), taking medication for their MH (29% v 5%, P< 0.001) & starting counseling (14% v 0%, P=0.001).

Almost half ECs desired support programs to cope with their condition (49% v 21%, P< 0.001), indicating virtual programs on coping with illness, MH resources & virtual support groups would be most helpful.

Conclusion: Despite limitations due to a convenience sample, results contribute to research on the psychosocial impact of the pandemic on rheumatic disease patients—the toll on emotional health & increased isolation. The significant differences found in those who reported an emotional change vs. those who did not support the need for the care team to assess & address MH issues during the pandemic. Further study is needed to assess long-term impacts.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-psychosocial-impact-of-the-covid-19-pandemic-on-the-rheumatology-patient-experience/