AB0848 PARTICIPATION OF UNDERGRADUATE MEDICAL STUDENTS AS INVESTIGATORS IN A RHEUMATOLOGIC COHORT: IMPACT ON DEPRESSION, ANXIETY &amp; STRESS SCALE
Authors: S. Basualto, J. V. Ziroldo Lopes, A. Rizzo Borges, M. Abreu, C. Albuquerque, N. Araújo, A. B. Bacchiega, B. Bica, D. Brito, A. Duarte, P. Realle, G. Ferreira, K. Wagner Poti Gomes, A. K. Melo, B. Stadler, A. Maria Kakehasi, E. Klumb, H. Mariz, C. Marques, L. Mota, G. Munhoz, E. Paiva, H. Pereira, G. Salviato Pileggi, M. Pinheiro, J. R. Provenza, A. P. Gomides, E. Reis Neto, S. Ribeiro, E. Sato, T. Laroca Skare, V. De Souza, M. L. M. Teodoro, L. D. D. A. Valadares, V. Valim, D. Calderaro
Journal: Annals of the Rheumatic Diseases (2021)

Background: Mental health was widely affected during the new coronavirus pandemic. In addition, some measures adopted by most countries in order to contain the virus spread, such as isolation and social distancing, leading to the interruption of routine activities, including partial or complete interruption of face-to-face classes may be associated with increased stress, depression and anxiety among undergraduate medical students (1). From March to September, 2020, the Brazilian Society of Rheumatology carried out the Mario Pinotti II Project (MPII), a prospective, multicenter, observational cohort study designed to monitor the COVID-19 in patients with rheumatic disease on hydroxychloroquine, using periodic telephone calls performed by undergraduate medical students (2). Objectives: To compare the mental health status of medical students who were participating from the MPII with theirs colleagues not involved in this project. Methods: A web-based survey via google forms platform was developed by a panel composed of undergraduate medical students, rheumatologists, medical school professors, and a psychology professor. It included details on demographic and life habits data and domains regarding depression, anxiety and stress, using the DASS-21 (Depression, Anxiety &amp; Stress Scale), Brazilian version. Data collection occurred from July 20th to August 31st, 2020. Statistical analysis was performed using the SPSS version 20.0. Univariate and multivariate linear regression analysis were performed to verify associations with the DASS-21, defined as dependent variable. A p-value &lt; 0.05 was deemed as significant. This study was approved by the Institutional Research Ethics Committee. Results: A total of 684 undergraduate medical students were included in this study, of whom 228 as MPII volunteers (VG) and 456 as control group (CG). Median age was 23 years (IQ 21-24) and the CG was older than the VG (p&lt;0.03). Most of them were white (68.8%) and women (63%). There were no significant differences regarding comorbidities, ethnicity, smoking status, alcohol intake and physical activity. Older age, male gender, participation of MPII study, absence of a worsening in sleep pattern during the pandemic and a lower number of prior comorbidities were associated with lower DASS21 scores, suggesting a better mental health (Table 1). Conclusion: Several aspects may be involved with mental health, including increased emotional maturity, gender and sleep pattern. Although with marginal independent association, medical students with participation in the MPII study had better mental health than their student colleagues not engaged with this research. Our data pointed out that voluntary participation in a research project which foresees interaction by telephone contact with rheumatic patients, professors, rheumatologists, and colleagues is associated with better mental health. References: [1]Meo SA, Abukhalaf AA, Alomar AA, Sattar K, Klonoff DC. Covid-19 pandemic: Impact of quarantine on medical students’ mental wellbeing and learning behaviors. Pakistan J Med Sci 2020;36(COVID19-S4):S43–8. [2]Gomides A, Ferreira G, Kakehas A, Lacerda M, Marques C, Paiva E et al. Impact of chronic use of antimalarials on SARS-COV-2 infection in patients with immune-mediated rheumatic diseases: protocol design for a multicentric observational cohort in Brazil. JMIR Research Protocols, 2020.Preprint Table 1. Univariate and multivariate analysis of predictors associated to the DASS-21 in undergraduate medical students during the COVID-19 pandemic Univariate analysis Multivariate analysis Variable B 95%CI p-Value B 95%CI p-Value Age -0.32 -0.61 to -0.03 0.03 -0.47 -0.81 to -0.13 0.008 Female gender 4.88 3.021 to 6.76 &lt;0.001 - - - Stable love relationship -2.49 -4.35 to -0.64 0.008 -2.5 -4.4 to -0.59 0.01 Number of previous comorbidities reported 4.69 3.71 to 5.68 &lt;0.001 4.82 3.73 to 5.92 &lt;0.001 MP-II volunteering -2.81 -4.74 to -0.86 0.005 - - - Worsening in sleep pattern 6.41 4.62 to 8.20 &lt;0.001 5.01 3.07 to 6.96 &lt;0.001 Disclosure of Interests: None declared