Impact of the COVID-19 Pandemic on the Appropriateness of Diagnostic Pathways of Autoimmune Rheumatic Diseases

Abstract

Objective Early diagnosis of autoimmune rheumatic diseases (ARD) is key to achieving effective treatment and improved prognosis. The coronavirus disease 2019 (COVID-19) pandemic has led to major changes in clinical practice on a global scale. We aimed to evaluate the impact of the COVID-19 pandemic on rheumatological clinical practices and autoimmunity testing demands. Methods Data regarding first rheumatological visits and new diagnosis together with the autoimmunity laboratory testing volumes related to COVID-19 pandemic phase (January- December 2020), were collected from medical records and laboratory information system (LIS) of a regional reference hospital (Basilicata, Italy) and compared with those obtained during the corresponding period in 2019. Results A significant decrease in the 2020 autoimmunity laboratory test volume was found when compared with the same period in 2019 (9912 vs 14100, p<0.05). A significant decrease in first rheumatological visits and diagnosis (1272 vs 2336, p<0.05) was also observed. However, an equivalent or higher percentage of positive autoimmunity results from outpatients services were recorded during 2020 when compared to pre-pandemic state. Of note, COVID- 19 associated decline in new diagnosis mainly affected less severe diseases. In contrast, ARD with systemic involvement were diagnosed at the same levels as the pre-pandemic period. Conclusion The COVID-19 pandemic has impacted on the access to health services. However, our study highlighted that during the outbreak, greater appropriateness of the requests of laboratory test and visits emerged as shown by a greater percentage of positive testing results and new diagnosis of more severe ARD compared to pre-pandemic period.

Changes in Service Delivery and Access to Rheumatologists Before and During the COVID-19 Pandemic in a Canadian Universal Healthcare Setting

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Autoimmune hepatitis and COVID-19: No increased risk for AIH after vaccination but reduced care

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Trends in mortality in patients with systemic autoimmune rheumatic diseases (SARD) during the COVID-19 pandemic in Mexico

“…The COVID-19 pandemic affected access to health services, with frequent avoidance of office visits and laboratory testing, particularly in the early months of the pandemic [ 7 , 8 ]. Interruptions in taking disease-modifying antirheumatic drugs also commonly occur without the advice of a physician [ 8 ].…”