Background The coronavirus disease 2019 (COVID-19) global pandemic is a highly stressful event that may contribute to psychological symptoms, particularly in patients with pre-existing chronic conditions. This study examined COVID-19 pandemic related stress experienced by patients with systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA) and its association with symptoms of psychological distress.
Methods An on-line cross-sectional survey study was conducted with 55 SLE (mean age = 54.8, ±13.8) and 42 RA (mean age = 64.2, ±12.2) patients recruited from a tertiary care centre in Quebec City between May 25, 2021 and June 13, 2021. Participants completed the COVID-19 Stressors Questionnaire adapted by our team for inflammatory arthritis. The Impact of Event Scale-Revised (IES-R) assessed post-traumatic stress symptoms (PTSS) caused by the COVID-19 pandemic. The Patient Health Questionnaire-8 (PHQ-8) and the Generalized Anxiety Disorder-7 (GAD-7) measured symptoms of depression and anxiety, respectively.
Results Among respondents 3/97 had been diagnosed with COVID-19 since the start of the pandemic (SLE=2, RA=1). Clinically significant PTSS (IES-R score ≥24) due to the COVID-19 pandemic was reported by 13.4% of participants, with no statistically significant difference between both disease groups (SLE = 16.4%; RA=9.5%). The degree of concern related to COVID-19 stressors were similar in both disease groups (SLE: M = 10.0 ±8.2; RA: M = 8.7 ±9.5). As shown in table 1, COVID-19 stressors that were associated with the highest degree of concerns were: having a loved one contract coronavirus (SLE 50.9%; RA 28.6%), the possibility of contracting (SLE 45.5%; RA 35.7%) or getting sick from coronavirus (SLE 40%; RA 21.4%), working in a place with high likelihood of exposure (SLE 30.9%; RA 21.4%), and the possibility of their disease worsening or being poorly managed due to changes in medical care (SLE 27.3%; RA 26.2%). In patients with SLE, a higher level of concern related to COVID-19 stressors was significantly correlated with greater symptoms of PTSS (r = 0.46, p < 0.001), depression (r = 0.46, p < 0.001) and anxiety (r = 0.62, p < 0.001). In patients with RA, a higher level of concerns related to COVID-19 stressors was significantly correlated with greater symptoms of PTSS (r = 0.33, p -0.036), but not with symptoms of depression and anxiety.
Conclusions Stressors related to the COVID-19 pandemic are experienced by an important proportion of patients with SLE and RA and are associated with psychological symptoms, particularly for patients with SLE.
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