Psychological Distress in Patients with Autoimmune Arthritis during the COVID-19 Induced Lockdown in Italy

Picchianti-Diamanti, Andrea; Cattaruzza, Maria Sofia; Rosa, Roberta; Porto, Flavia Del; Salemi, Simonetta; Sorgi, Maria Laura; Martin, Luis Severino Martin; Rai, Alessandra; Iacono, Dalila; Sesti, Giorgio; Alessandri, Guido; Laganà, Bruno

doi:10.3390/microorganisms8111818

Cited by 27 publications

(23 citation statements)

References 62 publications

(124 reference statements)

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“…In another study from Italy Diamanti et al investigated psychological distress in 100 patients with autoimmune arthritis and 100 controls during the Covid-19 pandemic. They found that the percentages of increased stress scores (46% vs 32%), depression (42% vs 36%) and anxiety (38% vs 25%) of arthritis patients were significantly higher than controls [ 30 ]. In our study group, 46.2% of kidney transplant recipients had high-perceived stress related to Covid-19, 44.3% of the patients had depression, 23.6% of the patients had anxiety.…”

Section: Discussionmentioning

confidence: 99%

The association between perceived stress with sleep quality, insomnia, anxiety and depression in kidney transplant recipients during Covid-19 pandemic

2021

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Background The psychological distress and sleep problems caused by current Covid-19 outbreak is not well known in kidney transplant recipients. In this study, we aimed to investigate the association between perceived stress with sleep quality, insomnia, anxiety, depression and kidney function in kidney transplant recipients during the Covid-19 pandemic. Material and methods A hundred-six kidney transplant recipients were enrolled. Questionnaire of "Socio-demographics", "Perceived Stress Scale (PSS)", "Pittsburgh Sleep Quality Index (PSQI)", "Insomnia Severity Index (ISI)" and “Hospital Anxiety Depression Scale (HADS)” are performed. The laboratory data is recorded. The perceived stress related to Covid-19 pandemic and its associations were investigated. Results The mean age of patients was 44.2±13.3 years, and 65 of the patients (61.3%) were men. Forty-nine (46.2%) of the patients had high-perceived stress; 51 (48.1%) of the patients had poor sleep quality, 40 (37.7%) of the patients had insomnia, 25 (23.6%) of the patients had anxiety and 47 (44.3%) of the patients had depression. The patients having a history of Covid-19 infection in own or closed relatives (9.09±4.17 vs 6.49±4.16, p:0.014) and the patients who have a rejection episode any of time (8.24±5.16 vs 6.37±3.57, p:0.033) have had significantly higher anxiety scores, when they compared to others. The high PSS were positively correlated with PSQI, ISI, HAD-A and HAD-D. Regression analyses revealed that high-perceived stress is an independent predictor of anxiety and depression. There was not significant difference between kidney function with PSS, PSQI, ISI, HAD-A and HAD-D. Conclusions High PSS is positively correlated with poor sleep quality and insomnia and also an independent predictor of anxiety and depression in kidney transplant recipients during the outbreak of Covid-19. As the pandemic is still spreading worldwide quickly early identification and intervention of sleep disturbances and psychiatric disorders are essential to protect graft function with high compliance to treatment in transplantation patients.

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Section: Discussionmentioning

confidence: 99%

The association between perceived stress with sleep quality, insomnia, anxiety and depression in kidney transplant recipients during Covid-19 pandemic

2021

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“…Indeed, throughout the COVID-19 pandemic, physicians and patients have developed several concerns on the use of immune-modulating therapies in patients with IMIDs, mainly due to their ability to increase the risk of infectious disease. In addition, logistical difficulties in reaching the hospitals for continue therapy has been showen [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…In this context, a main challenge is whether to modify/suspend the ongoing immunosuppressive treatment in IMID patients; clinicians indeed have to consider both the potential risk of an increased infectious exposure and that of disease relapse induced by therapy suspension. The management of IMID patients during the COVID-19 pandemic has become significantly more complex for other reasons such as the limited access to primary care or the contradictory messages on the protective/causative role of the immunosuppressor for SARS-CoV-2, which can fuel psychological distress and lead to a reduction in compliance and adherence to the immune-suppressor therapy [ 7 ]. For these reasons, we aim to study the risks of infections, hospitalizations, or mortality related to COVID-19 in a cohort of patients with rheumatoid arthritis (RA), psoriasis (PSO), or inflammatory bowel diseases (IBD).…”

Section: Introductionmentioning

confidence: 99%

Direct and Indirect Impact of COVID-19 for Patients with Immune-Mediated Inflammatory Diseases: A Retrospective Cohort Study

Belleudi¹,

Rosa²,

Poggi³

et al. 2021

JCM

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Importance: Since the beginning of the Coronavirus Disease-19 (COVID-19) pandemic, Severe Acute Respiratory Syndrome-CoV-2 (SARS-CoV-2) infection has been a serious challenge for immune-compromised patients with immune-mediated inflammatory diseases (IMIDs). Objective: Our aim was to investigate the impact of COVID-19 in terms of risks of infection, hospitalization and mortality in a cohort of patients with rheumatoid arthritis (RA), psoriasis (PSO) or inflammatory bowel disease (IBD). Furthermore, we studied the impact of SARS-CoV-2 infection on the prescribed drug regimen in these patients. Methods: Through the record linkage between health information systems, a cohort of patients, ≥18 years old, assisted in the Lazio region and who had suffered from immune-mediated inflammatory diseases (RA, PSO, IBD) between 2007 and 2019, was identified. The risk of infection, hospitalization or mortality for COVID-19, was assessed by logistic regression models, and reported in an Odds Ratio (ORs; CI 95%), adjusting for sex, age and the Charlson Comorbidity Index. We also estimated these risks separately by IMID and in the subgroup of prevalent biologic drug users. We investigated deferral of biological treatments in the study population by comparing the prevalence of weekly use of biologicals (2019–2020) before and during the pandemic periods. Findings: Within the 65,230 patients with IMIDs, the cumulative incidence for COVID-19 was 303/10,000 ab. In this cohort of patients, we observed a significantly higher risk of SARS-CoV-2 infection than the general population: OR = 1.17 (95% CI 1.12–1.22). The risk was higher even considering separately each disease and in the subgroup of prevalent biologic drug users. This last subgroup of patients showed a higher risk of death related to COVID-19 (OR 1.89; 95% CI 1.04–3.33) than the general population. However, no differences in terms of risks of hospitalization or death related to COVID-19 were recorded in patients with the IMIDs. Comparing the 2019–2020 prevalence of weekly biological drug treatments in prevalent biologic drug users, we found a decrease (−19.6%) during the lockdown, probably due to pandemic restrictions. Conclusions and Relevance: Patients with IMIDs seem to have a higher risk of SARS-CoV2 infection. However, other than for patients with prevalent biologic drug treatment, no significant differences in terms of hospitalization and mortality were reported compared to the general populations; further investigation is warranted on account of unmeasured confounding. In addition, during the lockdown period, the COVID-19 emergency highlighted a lower use of biologic drugs; this phenomenon requires strict pharmacological monitoring as it could be a proxy of forthcoming long-term clinical progression.

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“… 7 - 9 Higher psychological distress related to the COVID-19 pandemic were reported among patients with autoimmune arthritis in Italy. 10 However, studies examining psychological impact in patients with rheumatic diseases are limited globally and none in Malaysia.…”

Section: Introductionmentioning

confidence: 99%

A Questionnaire-based Survey on Depression and Anxiety among Rheumatology Patients during the COVID-19 Pandemic: Patient’s Perspective

Lim¹,

Tay²,

Bhullar³

et al. 2021

Oman Med J

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Objectives: The Coronavirus Disease 2019 (COVID-19) outbreak is a global pandemic and has caught the attention of the rheumatology fraternity, where patients are thought to be at higher risk of infection. We aimed to study the incidence of COVID-19 infection and depression and anxiety symptoms among patients with rheumatic disease (RD) in Hospital Selayang, Malaysia, during the COVID-19 pandemic. Methods: A crosssectional study was conducted via phone interview using a structured questionnaire in patients with RD aged > 18 years old scheduled for clinic appointments from 4 to 28 May 2020, which coincided with the second wave of COVID-19 cases in Malaysia. The questionnaire included demographics, COVID-19 screening questions, depression and anxiety symptoms screening using questions derived from the Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2). Results: Among the 361 patients enrolled, the majority were females (83.1%), and over half (54.3%) were ethnic Malays, 41.6% had rheumatoid arthritis, 34.6% had systemic lupus erythematosus, 12.2% had spondyloarthropathy, and only one (0.3%) patient had COVID-19 infection. The mean age of patients was 48.2 years (range: 16–80 years). The frequency of patients with depression and anxiety symptoms was 8.6% and 6.9%, respectively. Married patients reported feeling more anxious (p = 0.013), while patients with tertiary education levels reported feeling more depressed (p = 0.012). Conclusions: The incidence of COVID-19 infection is low, probably due to the low rate of testing. Depression and anxiety symptoms reported by patients in our cohort were modest. Our findings suggest that the COVID-19 pandemic has a greater impact on married patients with RD and those with a higher education level.

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Psychological Distress in Patients with Autoimmune Arthritis during the COVID-19 Induced Lockdown in Italy

Cited by 27 publications

References 62 publications

The association between perceived stress with sleep quality, insomnia, anxiety and depression in kidney transplant recipients during Covid-19 pandemic

The association between perceived stress with sleep quality, insomnia, anxiety and depression in kidney transplant recipients during Covid-19 pandemic

Direct and Indirect Impact of COVID-19 for Patients with Immune-Mediated Inflammatory Diseases: A Retrospective Cohort Study

A Questionnaire-based Survey on Depression and Anxiety among Rheumatology Patients during the COVID-19 Pandemic: Patient’s Perspective

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