Investigation Confirms COVID-19 Concerns in People with Rheumatic Disease

Investigators in New Zealand confirmed that fears among people with rheumatoid arthritis or ankylosing spondylitis in New Zealand about COVID-19 revolved around age, health, and medications used to treat their condition.

The investigators, led by Gareth J. Treharne, associate professor, Department of Psychology, University of Otago, cited the high burden of disability in patients with rheumatic disease.

During various lockdown phases in New Zealand, patients with rheumatic disease experienced fatigue or disability due to limited physical activity, a lack of regular consultations, increased susceptibility to infections, and concerns over whether immunosuppressing medications increased their risk of contracting COVID-19.

Because of these experiences, it was believed that this patient population were more likely to experience fear regarding the implications of the pandemic.

In the present study, Treharne and colleagues tested whether fears about COVID‐19 and perceived risk of exposure were associated with demographics, disruptions to consultations, current types of medications, and current aspects of health and disability for people with rheumatoid arthritis or ankylosing spondylitis.

The Study

A total of 126 participants were enrolled in the study through the Patient Opinion Real-Time Anonymous Liaison (PORTAL) study, an existing database that enrolled patients through their rheumatologist in 2015.

Additional participants were recruited in 2018 through the Dunedin Hospital Rheumatology Outpatients Clinic and from a database of patients who participated in the Spondylarthritis Genetics and the Environment study.

Participants self‐reported their age, gender, ethnicity, disease duration, medication types/dosages, education, and more. They also self-reported whether they had received a COVID-19 vaccine and documented various fears and other information through the 15-item COVID‐19 Questionnaire for Chronic Medical Conditions.

Investigators noted that age and medical characteristics did not account for a statistically significant proportion of the variance in perceived risk, but being tested for the virus did.

The Results

Treharne and colleagues found that COVID-19 fears were higher in younger people and those who had been tested for COVID-19 in Aoteoria, New Zealand, which they speculated were related to the flares thar occurred in the initial lockdown.

Perceived risk was also higher in that patient group, and taking biologic medications were associated with that perceived risk.

The investigators considered the increased fear and perceived risk of patients with rheumatic disease to be “understandable”, adding that the global pandemic became personal once an individual was tested themselves.

Though the study did uncover insights into how this vulnerable population perceived the pandemic, and even how that perception positively impacted infection rates, the investigators noted that limit to the level of fear or perceived risk that one can experience before it has a negative effect on wellbeing or adherence with public health measures was not considered.

“Therefore, future research could further explore the relationship between fear/perceived risk and complying with public health measures,” the team wrote.

The study, “Fears about COVID-19 and perceived risk among people with rheumatoid arthritis or ankylosing spondylitis following the initial lockdown in Aotearoa New Zealand,” was published online in Musculoskeletal Care.