AB0891-HPR PATIENTS WITH RHEUMATIC DISEASE WHO WERE ‘FEELING STRESSED’ DURING THE SECOND WAVE COVID19 INFECTION
Authors: H. Baharuddin, S. L. Lim, S. S. Ch’ng, M. Mohd Zain, A. Rosman, H. Mohd Yusoof, A. K. B. Authar Singh, V. Y. Tay
Journal: Annals of the Rheumatic Diseases (2021)

Background: COVID-19 pandemic has been devastating not only medically but also socially and economically. Selangor, an urbanised state in Malaysia, has been severely affected by COVID19. There is concern that patients with rheumatic diseases (RD) may have higher risk of infection, with increased mortality 1 . Objectives: To investigate patients’ characteristics which are associated with ‘feeling stressed’ among patients with RD during the second wave of COVID19 infection in Selangor. Methods: This is a cross-sectional study conducted over 3 weeks during the second wave of COVID19 infection in Malaysia. Patients with RD, scheduled for rheumatology clinic appointment in a rheumatology referral centre were invited to participate in this study. Personal and clinical data were collected by phone interview and from patients’ medical records respectively. Patients were asked to grade their disease activity by giving a score from 0 (not active) to 10 (active). All patients were asked ‘are you feeling stressed?’ and the answer was recorded as yes or no. Reasons explored for a yes answer, included financial, social disruption, physical illness and future uncertainties. Categorical and continuous data were analysed using chi-squared test and student t-test, respectively. A p-value of &lt;0.05 is considered statistically significant. Results: Three hundred and sixty-one patients with various RD participated in this study. The mean age of these was 48.2 years (range between 16-80 years). More than half (54.3%) were Malay and other ethnicities were Chinese (25.5%), Indian (18.2%) and others (2%). A quarter of patients (24.7%) were not working (unemployed, retired and students) and a third of patients (32.1%) had unpaid work (mainly housewife). The other patients’ characteristics are shown in Table 1. Table 1. Characteristics of patients who were ‘feeling stressed’ and not ‘feeling stressed’ during the second wave of COVID19 infection. Patients’ characteristics No of patients Feeling stressed (n=83), no of patients (%) Not feeling stressed (n=278), no of patients (%) p-value Age &lt;60 272 72 (26.5) 200 (73.5) 0.006 ≥60 89 11 (12.4) 78 (87.6) Gender Male 61 16 (26.2) 45 (73.8) 0.510 Female 300 67 (22.3) 233 (77.7) Ethnicity Malay 196 38 (19.4) 158 (80.6) 0.076 Others 165 45 (27.3) 120 (72.7) Relationship status Married 275 59 (21.5) 216 (78.5) 0.215 Unmarried 86 24 (27.9) 62 (72.1) Education level Up to secondary 233 48 (20.6) 185 (79.4) 0.145 Tertiary 128 35 (27.3) 93 (72.7) Work status No work 89 13 (14.6) 76 (85.4) 0.002 Unpaid work 116 20 (17.2) 96 (82.8) Paid work 156 50 (32.1) 106 (67.9) Rheumatic disease SLE 125 30 (23.8) 96 (76.2) 0.259 RA 150 30 19.4) 125 (80,6) Others 80 23 (28.8) 57 (71.3) Perceived disease activity 3.14 (2.4) 1.87 (2.1) &lt;0.001 Use biologics Yes 25 7 (28) 18 (72) 0.537 No 336 76 (22.6) 260 (77.4) Eighty-three (23%) admitted to ‘feeling stressed’ and the stressors identified were physical illness in 34 (40.9%), social disruption in 23 (27.7%), financial problems in 23 (27.7%) and future uncertainties in 19 (22.9%). Patients’ characteristics that were significantly different between patients who were ‘feeling stressed’ and not ‘feeling stressed’ were age, employment status and perceived disease activity (Table 1). Conclusion: The COVID19 pandemic has caused mental distress in a significant number of RD patients and associations were found with older age, having paid work and perceived disease activity. Issues that may influence patients’ responses, including access to rheumatology care, medication and fear of getting infection were not explored in this study. References: [1]Williamson EJ, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature, 2020; 584: 430–436. Disclosure of Interests: None declared