AB0675 COUNTRY COMPARISON ON THE IMPACT OF THE COVID-19 PANDEMIC ON PATIENTS WITH RHEUMATIC DISEASES. RESULTS FROM THE REUMAVID STUDY (PHASE 1)
Authors: M. Garrido-Cumbrera, H. Marzo-Ortega, L. Christen, L. Carmona, J. Correa-Fernández, S. Sanz-Gómez, E. Mateus, S. Makri, P. Plazuelo-Ramos, L. Grange, S. Mingolla, K. Antonopoulou, D. Webb, C. Jacklin, S. Irwin, V. Navarro-Compán
Journal: Annals of the Rheumatic Diseases (2021)

Background: The COVID-19 pandemic has impacted every aspect of life of European patients with rheumatic and musculoskeletal diseases (RMDs). Objectives: The aim is to evaluate country differences on the impact of the first wave of the COVID-19 pandemic on life habits, healthcare access, health status, mental health and wellbeing in European patients with RMDs. Methods: REUMAVID is an international collaboration led by the Health &amp; Territory Research group at the University of Seville, together with a multidisciplinary team including patient organisations and rheumatologists. This cross-sectional study consisting of an online survey gathering data from patients with a diagnosis of 15 RMDs in Cyprus, France, Greece, Italy, Portugal, Spain, and the United Kingdom. Participants were recruited by patient organisations (April-July 2020). The Kruskal-Wallis and χ 2 tests were used to analyse differences between countries and independent variables. Results: 1,800 patients participated in the first wave of the COVID-19 pandemic (REUMAVID). 37.8% of Spanish patients increased their smoking consumption during the pandemic followed by Cyprus (32.1%) and Portugal (31.0%), while alcohol consumption was higher in the UK (36.3%) and France (27.0%). 82.3% of patients in Spain unable to attend their appointment with their rheumatologist, either due to cancellations or other personal reasons. Access to primary care was most limited in Portugal and Italy, where only 45.0% and 51.6% got access. 61.9% in Italy and 53.3% in Spain experienced a worsening of their health during the pandemic. 68.5% in Spain and 67.8% in Portugal were at risk of anxiety. The highest proportion at risk of depression was found in Greece (55.4%), Cyprus (55.1%), and Italy (54.8%). 66.9% of patients in Spain reported poor wellbeing, compared to 23.8% in Italy and 30.1% in Portugal (Table 1). Conclusion: The first wave of the pandemic and the related containment measures heterogeneously affected patients with RMDs across European countries, who overall increased harmful habits, experienced more difficulties in accessing healthcare and, reported poor mental health and well-being. Table 1. Bivariate analysis between European countries (N=1,800, unless specified) Mean ± SD or n (% ) UK n: 558 Spain n: 464 France n: 229 Greece n: 57 Cyprus n: 101 Italy n: 127 Portugal n: 264 - Inflammatory arthritis 1 509 (91.2) 402 (86.6) 147 (64.2) 33 (57.9) 57 (56.4) 89 (70.1) 120 (45.5) - Fibromyalgia 53 (9.5) 14 (3.0) 26 (11.4) 14 (24.6) 28 (27.7) 53 (41.7) 124 (47.0) - Connective tissue disease 2 36 (6.5) 15 (3.2) 13 (5.7) 25 (43.9) 33 (32.7) 30 (23.6) 61 (23.1) - Osteoarthritis 140 (25.1) 29 (6.3) 102 (44.5) 0 (0.0) 8 (7.9) 15 (11.8) 13 (4.9) - Osteoporosis 50 (9.0) 3 (0.6) 20 (8.7) 2 (3.5) 9 (8.9) 18 (14.2) 12 (4.5) - Vasculitis 3 9 (1.6) 1 (0.2) 6 (2.6) 3 (5.3) 3 (3.0) 5 (3.9) 9 (3.4) - Sapho (only France) 15 (6.6) Smoking, More than before. N= 556 16 (10.3) 48 (37.8) 22 (24.7) 8 (23.5) 9 (32.1) 8 (20.5) 26 (31.0) Alcohol consumption, More than before. N= 1,085 99 (36.3) 48 (10.3) 27 (27.0) 4 (7.0) 4 (4.0) 4 (13.3) 11 (18.3) Unable to meet rheumatologist. N= 722 83 (48.8) 186 (82.3) 27 (30.3) 18 (64.3) 22 (51.2) 9 (31.0) 77 (56.2) Access to primary care. N= 689 87 (76.3) 65 (67.7) 32 (76.2) 14 (60.9) 17 (60.7) 65 (51.6) 117 (45.0) Change in health status, Much worse or worse. N=1,786 214 (38.4) 245 (53.3) 98 (43.0) 24 (42.9) 38 (38.4) 78 (61.9) 135 (51.9) WHO-5. Poor well-being (≤50). N= 1,777 292 (52.5) 303 (66.9) 100 (43.9) 21 (37.5) 46 (46.5) 30 (23.8) 78 (30.1) Risk of anxiety. N= 1,769 241 (43.6) 309 (68.5) 118 (52.0) 31 (55.4) 61 (62.2) 78 (61.9) 175 (67.8) Risk of depression. N= 1,769 186 (33.6) 232 (51.4) 101 (44.5) 31 (55.4) 54 (55.1) 69 (54.8) 138 (53.8) Note: all relations were significant at the 0.001 level. 1 Including: Axial Spondyloarthritis, Rheumatoid Arthritis, Psoriatic Arthritis, Juvenile Idiopathic Arthritis, Gout and Peripheral Spondyloarthritis; 2 Including: Systemic Lupus Erythematosus, Sjögren’s Syndrome, Systemic Sclerosis and Myositis; 3 Including: Polymyalgia Rheumatic and Vasculitis or Arteritis. Acknowledgements: This study was supported by Novartis Pharma AG. We would like to thank all patients that completed the survey as well as all of the patient organisations that participated in the REUMAVID study including: the Cyprus League Against Rheumatism (CYPLAR) from Cyprus, the Association Française de Lutte Anti-Rhumatismale (AFLAR) from France, the Hellenic League Against Rheumatism (ELEANA) from Greece, the Associazione Nazionale Persone con Malattie Reumatologiche e Rare (APMARR) from Italy, the Portuguese League Against Rheumatic Diseases (LPCDR), from Portugal, the Spanish Federation of Spondyloarthritis Associations (CEADE), the Spanish Patients’ Forum (FEP), UNiMiD, Spanish Rheumatology League (LIRE), Andalusian Rheumatology League (LIRA), Catalonia Rheumatology League and Galician Rheumatology League from Spain, and the National Axial Spondyloarthritis Society (NASS), National Rheumatoid Arthritis (NRAS) and Arthritis Action from the United Kingdom. Disclosure of Interests: Marco Garrido-Cumbrera: None declared, Helena Marzo-Ortega Speakers bureau: AbbVie, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Takeda and UCB, Consultant of: AbbVie, Celgene, Janssen, Lilly, Novartis, Pfizer and UCB, Grant/research support from: Janssen and Novartis, Laura Christen Employee of: Novartis Pharma AG, Loreto Carmona: None declared, José Correa-Fernández: None declared, Sergio Sanz-Gómez: None declared, Elsa Mateus Grant/research support from: Lilly Portugal, Sanofi, AbbVie, Novartis, Grünenthal S.A., MSD, Celgene, Medac, Janssen-Cilag, Pharmakern, GAfPA., Souzi Makri Grant/research support from: Novartis, GSK and Bayer., Pedro Plazuelo-Ramos: None declared, LAURENT GRANGE: None declared, Serena Mingolla: None declared, KATY ANTONOPOULOU: None declared, Dale Webb Grant/research support from: AbbVie, Biogen, Janssen, Lilly, Novartis and UCB, Clare Jacklin Grant/research support from: Abbvie, Amgen, Biogen, Eli Lilly, Gilead, Janssen, Pfizer, Roche, Sanofi &amp; UCB, Shantel Irwin: None declared, Victoria Navarro-Compán Grant/research support from: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, and UCB