Clinical impact of confinement due to the COVID-19 pandemic on patients with fibromyalgia: A cohort study

Abstract

Background: Data on the effect of the COVID-19 pandemic on fibromyalgia (FM) patients are lacking. FM patients often experience clinical impairment with stress situations.The objective of this study was to determine whether severity of FM increases because of confinement due to the COVID-19 pandemic.Methods: Prospective study including patients from the Combined Index of Severity of Fibromyalgia (ICAF) cohort who met the 2010 ACR FM criteria. In this cohort, all patients have a periodical evaluation of their quality of life through two questionnaires, the ICAF -which assesses the ability to perform daily living activities, anxiety and depression-, and through the Patient Global Impression of Change (PGIC), which assesses overall change after a therapeutical intervention. Pre and post-confinement measurements were analyzed. Inferential statistical analysis and ANOVA for repeated measurements were used.Results: A total of 93 patients received a phone consultation, (95.5% females), mean (SD) age of 48.23 (8.38) years. Four patients were excluded as presenting COVID-19 and 51 (57%) completed the post-confinement ICAF. Following confinement, 25 (49%) patients got worse (group worse) and 26 (51%) patients experienced no change or improved (group stable). Comparisons between pre and post confinement ICAF did not show significant differences in both groups. Passive coping was significantly different in group worse in pre-confinement evaluation. In the 80% of patients with passive coping predominance there were no change in coping strategy.Conclusions: No clinical impairment due to COVID-19 confinement occurred. The perceived worsening among FM patients relies primarily on how patients cope with their disease, without a real impact on clinical manifestations.

Has the COVID 19 Pandemic Impacted the Management of Chronic Musculoskeletal Pain?

“…Importantly, four studies highlighted the importance of positive coping strategies, including regular physical exercise, positive reappraisal, refocusing, and planning, and a high ability to self-manage pain. These coping methods helped mitigate the pandemic's impact on disease management, leading to an increase in wellbeing outcomes related to pain, sleep, anxiety, and depression [36,39,41,47]. In another study showing symptom improvements in fibromyalgia patients, authors suggested that positive outcomes were attributable to reduced social constraints and work pressure [38].…”

“…Despite four of the seven studies finding worsened clinical outcomes, three studies from Europe found no changes or slight improvements in fibromyalgia patient outcomes during the pandemic [36,38,39]. Within these studies, positive outcomes were mostly attributed to effective patients' coping skills [39] and their adaptability, including positive reappraisal and refocusing [36].…”

“…The rate of COVID-19 positive tests was 5-7% in two studies [33,37]. Two other studies excluded patients with a history of COVID-19 infection [35,39].…”

“…Seven studies with 2471 participants evaluated the effect of the COVID-19 pandemic on patients with fibromyalgia [33][34][35][36][37][38][39]. The sample size ranged from 38 to 965; 86-100% of patients were female.…”