AB0500 IMPACT OF COVID-19 PANDEMIC IN OVERALL HEALTH AND FUNCTIONING IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: RESULTS FROM THE REUMAVID STUDY (PHASE 1)
Authors: D. Benavent, M. Garrido-Cumbrera, C. Plasencia, L. Christen, H. Marzo-Ortega, J. Correa-Fernández, P. Plazuelo-Ramos, D. Webb, V. Navarro-Compán
Journal: Annals of the Rheumatic Diseases (2021)

Background: Evidence on the impact of the COVID-19 pandemic on the overall health and functioning in patients with axial spondyloarthritis (axSpA) is scarce. Objectives: To analyse the impact of the COVID-19 pandemic on the overall health and functioning in patients with axSpA. Methods: Data from axSpA patients participating in the first phase of the REUMAVID study were analysed. REUMAVID is a cross-sectional, observational study collecting data through an online questionnaire of unselected patients with rheumatic and musculoskeletal diseases (RMDs), recruited by patient organizations. The survey was disseminated during the beginning of the COVID-19 pandemic (April-July 2020) in seven European countries (Cyprus, France, Greece, Italy, Portugal, Spain, and the United Kingdom). Patients with axSpA who completed the ASAS health index (ASAS-HI) questionnaire were included in this analysis. Descriptive analyses were used to present socio-demographic and clinical characteristics, as well as daily habits. Overall health and functioning were defined according to the ASAS-HI (0-17), as follows: good health (ASAS-HI ≤5), acceptable health (ASAS-HI 6-11), and poor health (ASAS-HI ≥12). As secondary outcomes, well-being (WHO-5), self-perceived health status, and HADS for anxiety and depression were assessed. Results: Out of 670 axSpA patients, 587 (87.6%) completed ASAS-HI. Of these, 70.4% were female, 72.6% were married or in a relationship, 46.7% had university studies and 37.6% were currently employed. Mean age was 49.9±12.8 years and mean BMI was 26.7±5.5. Regarding extraarticular manifestations, 13.6% had psoriasis, 12.1% inflammatory bowel disease and 18.7% uveitis. Before the COVID-19 pandemic, 50.9% were receiving biological drugs, 46.3% NSAIDs, 26.4% painkillers, 24.7% conventional DMARDs, and 11.9% oral corticosteroids. According to the ASAS-HI, 19.6 % of patients were classified as having poor health, with the most affected aspects being pain (92.0%), movement (86.5%), maintenance of body position (80.6%), energy (79.0%) and sleep (75.3%). Regarding self-perceived health status, 14% reported their health status as “bad” or “very bad”, and 46.8% reported worsening health during the pandemic (Table 1). A distribution of the results of the total ASAS-HI scores can be seen in Figure 1. Table 1. Overall health and well-being, disease activity, and mental health. Primary Outcome (ASAS-HI ) Mean ± SD or n (% ) ASAS-HI (0-17), n=587 8.0 (±3.9) ASAS-HI &lt;5 (good health) 159 (27.1) 5-12 (acceptable health) 313 (53.3) ≥12 (poor health) 115 (19.6) Secondary Outcomes WHO-5 WHO-5, (0-100), n=584 46.3 (±23.1) WHO- 5 Poor wellbeing WHO- ≤50 330 (56.5) Self-perceived health status, n=585 Very good 33 (5.6) Good 214 (36.6) Fair 256 (43.8) Bad 69 (11.8) Very bad 13 (2.2) Change in health status during lockdown, n=587 Much worse than before 54 (9.2) Moderately worse 220 (37.6) Same as before 270 (46.0) Moderately better 35 (6.0) Much better than before 6 (1.0) HADS HADS Anxiety (0-21), n=587 8.4 (±4.1) HADS Anxiety No case (0-7) 248 (42.7) Borderline case (8-10) 151 (26.0) Case (11-21) 182 (31.3) HADS Depression (0-21), n=587 7.0 (±4.3) HADS Depression No case (0-7) 329 (56.6) Borderline case (8-10) 134 (23.1) Case (11-21) 118 (20.3) Figure 1. Distribution of the result of ASAS-HI scores (N= 587) Conclusion: One out of five patients with axSpA reported poor health and functioning according to the ASAS-HI, and almost half of patients reported worsening self-perceived health status during the first wave of the COVID-19 pandemic. Keywords : COVID-19, axial spondyloarthritis, ASAS-HI, health Disclosure of Interests: Diego Benavent Grant/research support from: Abbvie, Novartis and Roche, Marco Garrido-Cumbrera: None declared., Chamaida Plasencia Grant/research support from: Pfizer, Sanofi, Novartis, Roche and Lilly, Laura Christen Employee of: Novartis Pharma AG, Helena Marzo-Ortega Grant/research support from: Abbvie, Celgene, Janssen, Elli-Lilly, Novartis, Pfizer, UCB and Takeda Pharmaceutical Company, José Correa-Fernández: None declared., Pedro Plazuelo-Ramos: None declared., Dale Webb: None declared., Victoria Navarro-Compán Grant/research support from: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, UCB.