Did COVID-19 impact osteoarthritis – clinical perspective?

Abstract

Purpose of review To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on patients with osteoarthritis (OA). Recent findings The COVID-19 pandemic negatively affected patients with OA irrespective of them contracting the infection. Patients with OA had a disruption in access to the healthcare system, which resulted in delays in joint replacement surgeries from cancellations of elective surgical procedures. On the other hand, the pandemic accelerated the drive towards telemedicine and telerehabilitation, with many nonurgent services being delivered remotely whenever possible. Cross-sectional studies showed that the majority of patients with OA were willing to accept the increased risks of contracting the COVID-19 infection and proceed with elective joint replacement surgeries. Summary The American College of Rheumatology and the European League Against Rheumatism issued guidelines for managing immune-mediated rheumatic diseases during the pandemic. However, these guidelines did not include recommendations for patients with OA. Healthcare providers, including physical therapists, should aim to schedule more frequent telemedicine follow-up appointments to maximize medical management while patients await elective joint procedures.

COVID-19 and Hip Osteoarthritis Disability-Linkages and Emerging Practice Implications

“…In particular, because the presence of any SARS-CoV-2 infection could potentiate or accelerate a possible pre-existing systemic inflammatory state among those infected individuals suffering from obesity, special efforts to avoid weight gain and promote weight loss are likely to be more helpful than not [2]. In this regard the added value of techniques such as meditation related practices, guided imagery, joining an online support group, mild to moderate activity participation practices, healthy eating, social distancing, hand washing and optimal sleep routines may prove helpful as well [2,6,8].…”

“…Although often discounted as a major disabler of significant societal and individual importance by many, the collective public health impact, along with the immense suffering experienced by older adults diagnosed as having osteoarthritis of one or both hip joints, cannot be considered trivial. Yet, osteoarthritis, the most prevalent form of arthritis, was not even mentioned in a recent updated rheumatologic guideline document that was put forth in light of the COVID-19 pandemic [8]. At the same time, Quicke et al [9] report a Global Burden of Disease study reporting a 102% increase in crude incidence rate of osteoarthritis rates in 2017 compared to 1990 showing no progress in efforts to stem the onset and prevalence of this disabling disease in pre pandemic periods, despite years of related research that point to some possible preventable causes, such as obesity.…”

View of the Pathogenetic Mechanisms of Joint Damage in Coronavirus Disease 2019

“…Scientific sources suggest [5] that the inflammatory reaction in the organism caused by the SARS-CoV-2 virus, even of a low degree, can generate a large number of pro-inflammatory cytokines, which contributes to the destruction of cartilage, thus inducing of OA or worsening its course. Studies of the biochemical mechanisms of the potential effects of SARS-CoV-2 infection on cartilage degeneration or synovial inflammation in the joints are still at the initial stage [46].…”

Osteoarthritis: A contemporary view of the problem, the possibilities of therapy and prospects for further research

“…COVID-19 negatively influences on patients with chronic diseases including OA. Delay of nonemergency procedures due to COVID restrictions lead to a significant number of postponed joint replacement operations or cancellations of surgical or therapeutical procedures [23]. COVID control have reduced access to healthcare services most of them became through remote working (telemedicine, telehealth, virtual consultations) [24].…”

“…Restrictions of access to exercise facilities may lead to limitations in range of motion, hypodynamia and subsequent muscle atrophy of individuals with OA. So even in COVID quarantine patients are strongly advised to continue to exercise near or at home (walking, yoga, tai chi) and reduce weight with a healthy diet [23].…”