COVID‐19 and rheumatology: Reflecting on the first wave and preparing for the second wave

Fardanesh, Armin; Byravan, Swetha; Moorthy, Arumugam; Tahir, Hasan

doi:10.1111/1756-185x.14062

Cited by 4 publications

(3 citation statements)

References 12 publications

(17 reference statements)

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“…McDougal et al ’s tele-rheumatology systematic review found that most studies reviewed ‘demonstrated a high risk of bias’ [ 11 ]; and studies have produced conflicting results. Some report high levels of patient satisfaction [ 12 , 13 ] and suggest that telemedicine could be as effective as face-to-face for autoimmune rheumatic diseases [ 14 ]. However, there are concerns regarding the use of telemedicine for diagnosis and assessment of disease activity [ 15 ], particularly as a result of lack of physical examinations [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, there are concerns regarding the use of telemedicine for diagnosis and assessment of disease activity [ 15 ], particularly as a result of lack of physical examinations [ 16 ]. Studies to date have tended to be limited by sample size [ 14 ], only reporting the views of one side of the medical relationship and/or only including patients from the investigators’ hospital [ 13 , 17 ], which could increase the risk of bias.…”

Section: Introductionmentioning

confidence: 99%

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Telemedicine in rheumatology: a mixed methods study exploring acceptability, preferences and experiences among patients and clinicians

et al. 2021

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Objectives The Covid-19 pandemic necessitated a rapid global transition towards telemedicine; yet much remains unknown about telemedicine’s acceptability and safety in rheumatology. To help address this gap and inform practice, this study investigated rheumatology patient and clinician experiences and views of telemedicine. Methods Sequential mixed methodology combined analysis of surveys and in-depth interviews. Between and within-group differences in views of telemedicine were examined for patients and clinicians using t-tests. Results Surveys (Patients n = 1,340, Clinicians n = 111) and interviews (Patients n = 31, Clinicians n = 29) were completed between April 2021 and July 2021. The majority of patients were from the UK (96%) and had inflammatory arthritis (32%) or lupus (32%). Patients and clinicians rated telemedicine as worse than face-to-face consultations in almost all categories, although >60% found it more convenient. Building trusting medical relationships and assessment accuracy were great concerns (93% of clinicians and 86% of patients rated telemedicine as worse than face-to-face for assessment accuracy). Telemedicine was perceived to have increased misdiagnoses, inequalities and barriers to accessing care. Participants reported highly disparate telemedicine delivery and responsiveness from primary and secondary care. Although rheumatology clinicians highlighted the importance of a quick response to flaring patients, only 55% of patients were confident that their rheumatology department would respond within 48 hours. Conclusion Findings indicate a preference for face-to-face consultations. Some negative experiences may be due to the pandemic rather than telemedicine specifically, although the risk of greater diagnostic inaccuracies using telemedicine is unlikely to be fully resolved. Training, choice, careful patient selection, and further consultation with clinicians and patients is required to increase telemedicine’s acceptability and safety.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Telemedicine in rheumatology: a mixed methods study exploring acceptability, preferences and experiences among patients and clinicians

et al. 2021

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“…The most prevalent complications include pneumonia, respiratory failure, myocardial injury, renal failure, sepsis or complications related to thrombosis ( 1 ). There have also been reports of individuals experiencing a flare-up of autoimmune diseases following infection with SARS-CoV-2 ( 1 , 2 ). Over time, various mutated variants of COVID-19 have emerged and been identified.…”

Section: Introductionmentioning

confidence: 99%

A chronological review of COVID-19 case fatality rate and its secular trend and investigation of all-cause mortality and hospitalization during the Delta and Omicron waves in the United States: a retrospective cohort study

Li,

Liao,

Wei

et al. 2023

Front. Public Health

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IntroductionCoronavirus disease 2019 (COVID-19) has caused more than 690 million deaths worldwide. Different results concerning the death rates of the Delta and Omicron variants have been recorded. We aimed to assess the secular trend of case fatality rate (CFR), identify risk factors associated with mortality following COVID-19 diagnosis, and investigate the risks of mortality and hospitalization during Delta and Omicron waves in the United States.MethodsThis study assessed 2,857,925 individuals diagnosed with COVID-19 in the United States from January 2020, to June 2022. The inclusion criterion was the presence of COVID-19 diagnostic codes in electronic medical record or a positive laboratory test of the SARS-CoV-2. Statistical analysis was bifurcated into two components, longitudinal analysis and comparative analysis. To assess the discrepancies in hospitalization and mortality rates for COVID-19, we identified the prevailing periods for the Delta and Omicron variants.ResultsLongitudinal analysis demonstrated four sharp surges in the number of deaths and CFR. The CFR was persistently higher in males and older age. The CFR of Black and White remained higher than Asians since January 2022. In comparative analysis, the adjusted hazard ratios for all-cause mortality and hospitalization were higher in Delta wave compared to the Omicron wave. Risk of all-cause mortality was found to be greater 14–30 days after a COVID-19 diagnosis, while the likelihood of hospitalization was higher in the first 14 days following a COVID-19 diagnosis in Delta wave compared with Omicron wave. Kaplan–Meier analysis revealed the cumulative probability of mortality was approximately 2-fold on day 30 in Delta than in Omicron cases (log-rank p < 0.001). The mortality risk ratio between the Delta and Omicron variants was 1.671 (95% Cl 1.615–1.729, log-rank p < 0.001). Delta also had a significantly increased mortality risk over Omicron in all age groups. The CFR of people aged above 80 years was extremely high as 17.33%.ConclusionMale sex and age seemed to be strong and independent risk factors of mortality in COVID-19. The Delta variant appears to cause more hospitalization and death than the Omicron variant.

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Comment on short- and long-term prognosis of glycemic control in COVID-19 patients with type 2 diabetes

Chu

Wei

2022

QJM: An International Journal of Medicine

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COVID‐19 and rheumatology: Reflecting on the first wave and preparing for the second wave

Cited by 4 publications

References 12 publications

Telemedicine in rheumatology: a mixed methods study exploring acceptability, preferences and experiences among patients and clinicians

Telemedicine in rheumatology: a mixed methods study exploring acceptability, preferences and experiences among patients and clinicians

A chronological review of COVID-19 case fatality rate and its secular trend and investigation of all-cause mortality and hospitalization during the Delta and Omicron waves in the United States: a retrospective cohort study

Comment on short- and long-term prognosis of glycemic control in COVID-19 patients with type 2 diabetes

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