Management of Childhood Rheumatic Diseases During the COVID-19 Pandemic: A Survey on Parental Approaches and Involvements in the Treatment Procedure

Abstract

Objectives: This study aimed to seek the approaches of parents in medical management of their children with rheumatic disorders during the COVID-19 outbreak. Methods: This cross-sectional study was conducted based on an online questionnaire survey at Children’s Medical Center Hospital of Tehran University of Medical Sciences, Tehran, Iran. The participants were selected based on their institutional records. The questionnaires contained questions covering all the basic information related to the patients and their parents, as well as the approaches that parents had taken to manage the rheumatic disease of their children during the outbreak of COVID-19. Results: A total number of 125 valid questionnaires were collected. Based on our results, 13 out of 129 parents had discontinued their children’s medicines due to COVID-19 concerns, 4 had respiratory disease symptoms but 9 had not any signs of pulmonary involvements. Thus, the overall response rate was calculated 89.6%. However, among the symptomatic cases 19 out of 23 rheumatoid cases had continued to take their routine medications, and the response rate among this group was obtained 82.6%. Among these 13 cases, 7 children had worsened symptoms; however 6 had no changes in the disease symptoms. Seventy-six out of 125 children had been visited by a doctor in the last 2 months, while the remaining 49 cases did not. Twenty-three children (18.4%) had respiratory disease symptoms in the last two months, 19 of whom (82.6%) had continued their rheumatic drugs, but 4 (17.3%) had stopped. Only 3 of 125 children had confirmed COVID-19 infection. Conclusions: None of the parents who had visited a pediatric rheumatologist during this time had discontinued their children’s medicines. Therefore, close contact with doctors or online consultation could benefit them during the COVID-19 era.

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“…The 19 Pakistan 20 and Saudi Arabia 21 ; 3 studies described the delayed vaccination patterns among children in Saudi Arabia, [22][23][24] while 2 studies looked into children's behavioral changes in Qatar 25 and Egypt, 26 and 2 others tackled the impact of home confinement on children's relationship with their parents in Qatar 27 and Saudi Arabia. 28 Two papers analyzed the Poliomyelitis surveillance system performance indicators as well as national immunization activities taking place in Afghanistan and Pakistan.…”