Living with arthritis: a “training camp” for coping with stressful events? A survey on resilience of arthritis patients following the COVID-19 pandemic

Abstract

Resilience is defined as "the capacity of individuals to cope successfully with significant change or adversity". The challenge posed by the COVID-19 pandemic may potentially represent an overwhelmingly stressful event for patients with chronic diseases. Aim of our study was to investigate the levels of resilience in individuals with inflammatory arthritis living in Emilia Romagna, the third hardest-hit Italian region during the ongoing COVID-19 pandemic. To this purpose, we developed a survey consisting of four different sections assessing demographic characteristics, the 14-item resilience scale (RS14) and questionnaires evaluating depression and anxiety. Consecutive patients with inflammatory arthritis were recruited over a short time frame immediately after the end of national lockdown and compared with control individuals from the general population. One hundred twenty-two patients and 173 controls were included. Levels of resilience, as measured by RS14 score, were significantly higher in patients with inflammatory arthritis (82.6 ± 14.0 vs 79.0 ± 12.8, p = 0.018). After stratification for gender, the difference in RS14 score was maintained in women (p = 0.045), but not in men (p = 0.252). High resilience, defined as having a RS14 score > 90, was significantly more prevalent in patients than in controls (30% vs 16%, p = 0.009). In arthritis patients, no significant differences in RS14 were observed after stratification for specific diagnosis, age, or disease duration and activity. Our findings suggest that patients with inflammatory arthritis may be more resilient than the general population towards unexpected stressful events such as the ongoing COVID-19 pandemic.

Psychosocial and clinical effects of the COVID-19 pandemic in patients with childhood rheumatic diseases and their parents

“…Resilience can be defined as a multidimensional structure that explains the long-term positive effects resulting from the ability to adapt to threatening or traumatic experiences [ 39 ]. Resilience is strongly negatively correlated with depression and anxiety [ 38 ]. In our study, the similarity of depression and anxiety scores between the patient and control groups of children younger than 12 years and their parents may be related to the resilience that develops adaptively to the presence of chronic disease.…”

“…Patients with autoimmune diseases can develop stronger resilience as an adaptive response to the chronicity of their condition [36][37][38]. Resilience can be defined as a multidimensional structure that explains the long-term positive effects resulting from the ability to adapt to threatening or traumatic experiences [39].…”

The impact of COVID-19 on patients with hematological malignancies: the mixed-method analysis of an Israeli national survey

“…Thus, it is not surprising that during the COVID-19 pandemic, a 36% rate of anxiety and 31% rate of depression was recorded among lymphoma outpatients [ 10 ]. Coping styles associated with better QOL in cancer patients included emotional support and acceptance, [ 11 ] while living alone and insufficient social support seem to be associated with treatment non-adherence in patients with hematological malignancies [ 12 ] However in this respect, a recent study showed that patients with chronic conditions such as inflammatory arthritis seem to have a better capacity to successfully cope with stressful events during COVID-19 pandemic [ 13 ]. Nevertheless, this point was not truly evaluated among patients with hematological malignancies.…”

Vitamin D deficiency: concern for rheumatoid arthritis and COVID-19?

“…Various anti-rheumatic strategies, like IL-6 inhibitor (Tocilizumab) and JAK inhibitor (Baricitinib) are being investigated for COVID treatment [ 7 – 10 ]. Observational, meta-analysis and multi-omics approach-based studies indicate that the autoimmune disease group patients are at significant risk for COVID-19 infection [ 11 – 13 ] which calls for the inclusion of adjuvant therapies. In lieu of the above, we have reviewed here the scientific literature on vitamin D deficiency as a risk factor and its supplementation benefits in RA and COVID diseases.…”