Telerheumatology in COVID-19 era: a study from a psoriatic arthritis cohort

Abstract

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COVID-19 in Italian patients with rheumatic autoimmune systemic diseases

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Overall, the observed prevalence of symptomatic COVID-19, usually as mild-moderate disease, in patients with chronic arthritis was comparable to that found in the general population, while worse outcomes represented almost rare events. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Conversely, increased percentages of symptomatic COVID-19 were observed in patient cohorts with connective tissue diseases, especially systemic lupus or systemic vasculitis. 6 7 Of note, in ASD complicated by COVID-19, the baseline use of immune modifiers, namely, conventional synthetic (csDMARD), biological (bDMARD) and targeted synthetic disease-modifying antirheumatic drugs (tsDMARD), was not associated with worse COVID-19 disease outcomes.…”

“…We followed with great interest the numerous reports published by the Annals [1][2][3][4][5][6][7][8][9] as regards the impact of the COVID-19 pandemic on different rheumatic autoimmune systemic diseases (ASD), including the survey study by Costa et al 9 that underlined the usefulness of telerheumatology in the management of patients with psoriatic arthritis in COVID-19 era. On the same topic, the world literature encompasses a large number of anecdotal observations, cohort studies and telephone surveys.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Given the heterogeneous distribution of pandemic infection within the same country, we investigated the impact of COVID-19 in ASD patients' populations from three distinct regions of Italy (northern, Emilia Romagna; central, Tuscany; and southern, Calabria), characterised by different spread of the COVID-19 pandemic, prevalent in northern Italy with a marked gradient north-south. 16 Our 6-week multicentre telephone survey of 1641 unselected patients with ASD confirmed the quite benign clinical course of COVID-19 in ASD, along with the safety of baseline use of either bDMARD or tsDMARD [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] ; however, the survey revealed a significantly higher prevalence of (1) either definite COVID-19 (always confirmed by positive oral/nasopharyngeal swabs at PCR testing) or highly suspected COVID-19 (presence of fever and/or known contact with infected subject, and at least 4 out of 12 typical signs/symptoms of COVID-19) in patients with ASD compared with the Italian, or regional, general population; (2) definite COVID-19 plus highly suspected COVID-19 in connective tissue diseases (CTD)/vasculitis (703 patients) compared with the subgroup of chronic arthritis (938 patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis); and (3) definite COVID-19 plus highly suspected COVID-19 in ASD patients without ongoing csDMARD. 16 Although a number of issues still remain to be better investigated, we can draw some provisional considerations based on the whole of currently available data: ► The actual prevalence of COVID-19 in patients with ASD might be underestimated, possibly due to concurrent factors, mainly the high rate of mild COVID-19 variants, the frequent clinical overl...…”

May the analysis of 1918 influenza pandemic give hints to imagine the possible magnitude of Corona Virus Disease-2019 (COVID-19)?

“…As healthcare systems are very focused on COVID-19 care, the spread of the SARS-COV-2 also carry negative health effects, and an example is represented by limitation of access for chronic and not-surge diseases [139,140]. Economic effects cannot be separated from health effects, and interventions designed to control COVID-19 need to take account of consequences [141].…”

Response to: ‘Can telerheumatology improve rheumatic and musculoskeletal disease service delivery in sub-Saharan Africa?’ by Akpabioet al

“…1 Telehealth has to be focused on providing care, and the use of telemedicine to support long-distance or the practical impossibility of inperson care has increased strongly in parallel with the COVID-19 pandemic. [5][6][7] Each Italian region, including Campania, has tried to implement remote assistance systems above all to manage patients with chronic and rare diseases and to guarantee continuity of care even remotely-in some cases with telephone instant messaging or email-based and video consultations and in other cases with the help of ad hoc platforms.…”