A better but persistently low health status in women with fibromyalgia during the COVID-19 pandemic: a repeated cross-sectional data analysis

Abstract

Multiple overlapping and complementary theoretical arguments suggest that the COVID-19 pandemic could worsen health in fibromyalgia. The aim of this study was to determine mental and physical health in women with fibromyalgia before and during the pandemic. In a 3-sample, repeated cross-sectional design, we analyzed questionnaire data from Dutch women with fibromyalgia, collected in three independent samples: before the COVID-19 pandemic (2018; n = 142) and during the first acute (2020; n = 304) and prolonged (2021; n = 95) phases of the pandemic. Eight dimensions of mental and physical health were assessed using The RAND 36-Item Short Form Health Survey (RAND SF-36). Compared to norm group data, both before and during the pandemic, women with fibromyalgia showed high levels of fatigue and pain and low levels of general health, social functioning, physical functioning, role physical functioning (d > 1.2, very large effect sizes), role emotional functioning, and mental health (0.71 < d < 1.2, medium to large effect sizes). Contrary to theoretical expectation, levels at five health variables before vs. during the pandemic did not differ (p > 0.05), and levels of pain (p < 0.001), role physical functioning (p < 0.001), and physical functioning (p = 0.03) (0.014 ≤ pη2 ≤ 0.042, small effect sizes) reflected a healthier status during than before the pandemic. These findings indicate a somewhat better but persistently low health status in women with fibromyalgia during the pandemic. This suggests that the pandemic may include changed circumstances that are favorable for some women with fibromyalgia.

Modulating factors of fibromyalgia in women during the COVID-19 pandemic: A protocol for systematic review

“…Contrary to the previous studies is the research by Koppert et al, [ 28 ] which stated as a result that far from what might be expected during the pandemic, the severity of symptoms remained the same and even improved in some of the patients. The main difference between these studies is that in Koppert et al [ 28 ] no specific survey was applied for symptoms, but instead several health variables were taken into account.…”

“…Contrary to the previous studies is the research by Koppert et al, [ 28 ] which stated as a result that far from what might be expected during the pandemic, the severity of symptoms remained the same and even improved in some of the patients. The main difference between these studies is that in Koppert et al [ 28 ] no specific survey was applied for symptoms, but instead several health variables were taken into account. However, in the other studies, that is, Cankurtaran et al, [ 29 ] Hruschak et al, [ 25 ] Ingegnoli et al, [ 26 ] Macfarlane et al, [ 27 ] and Rivera et al, [ 24 ] specific surveys were applied for the symptom or pain variables.…”

“…The values were compared between men and women, with no differences found. Koppert et al [28] conducted a cross-sectional study involving 3 phases in which an online survey was conducted, the first 1 in November 2018 to May 2019 (before the pandemic), and the next 2 phases from March to May 2020, extending to 2021; these were periods with large numbers of deaths and hospitalizations due to COVID-19. Participants were mostly selected through social networks and they completed the surveys on a secure university website.…”

“…Table 2 shows a synthesis of the results obtained in the different studies included in the review. [24][25][26][27][28][29] The selected studies show assessments on how people affected with fibromyalgia evolved during the COVID-19 pandemic from a perspective focused on mental health and the evolution of symptoms, some of them also covering sleep patterns, anxiety, or fear. These studies had mostly women as study population, and those that did not meet this requirement provided data by sex.…”

“…Overall, all those who reported a worsening of symptoms or pain, whether significant or not, attributed this largely to psychosocial factors and mental health. These psychological factors are specially reinforced by the studies by Koppert et al [ 28 ] and Rivera et al [ 24 ] Also, as far as mental health is affected, all studies agreed that there was a worsening in people affected by fibromyalgia. The studies by Cankurtaran et al [ 29 ] and Ingegnoli et al [ 26 ] emphasized a significant increase in anxiety during the pandemic in people affected by fibromyalgia, and specifically the study by Ingegnoli et al [ 26 ] also mentioned that women suffered the most this increase in stress and anxiety.…”