AB0083 THE IMPACT OF COVID-19 AND ‘LONG COVID’ ON SELF-REPORTED DISEASE ACTIVITY, DISABILITY, AND QUALITY OF LIFE IN PEOPLE WITH INFLAMMATORY ARTHRITIS
Authors: Z. S. Wallace, M. Lin, X. Wang, N. Patel, Y. Kawano, A. Schiff, A. King, J. Hanberg, S. Srivatsan, E. Kowalski, C. Johnson, K. Vanni, Z. Williams, G. Qian, C. Bolden, K. Mueller, K. Bade, A. Saavedra, R. Venkat, J. A. Sparks
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> People with rheumatoid arthritis (RA), psoriatic arthritis (PsA), juvenile idiopathic arthritis (JIA), and axial spondyloarthritis (axSpA) are at risk for poor acute COVID-19 outcomes because of their disease, comorbidities, and/or treatments. Less is known about the impact of COVID-19 infection and 'long COVID' on post-acute COVID-19 outcomes in this vulnerable population, particularly with regard to rheumatic disease activity, disability, and quality of life. <h3>Objectives:</h3> To examine the association of COVID-19 infection and 'long COVID' with disease activity, disability, and quality of life in people with inflammatory arthritis. <h3>Methods:</h3> RheumCARD is a prospective cohort study recruiting people with systemic rheumatic disease with (cases) and without (comparators) a history of COVID-19 from a large US healthcare system. Participants are recruited ≥ 28 days after acute COVID-19 onset. Surveys include the Routine Assessment of Patient Index Data 3 (RAPID-3), modified health assessment questionnaire (MHAQ), short form 12 (SF-12), fatigue symptom inventory (FSI), and short form McGill Pain Questionnaire (SF-MPQ). Participants report rheumatic disease control (scale 0-10, 10 being well-controlled) before and after COVID-19 (cases) or test for COVID-19 (comparators). Here, we analyzed only participants with inflammatory arthritis (RA, PsA, JIA, or axSpA) who completed surveys 3/2021-10/2023. 'Long COVID' was defined as symptoms of acute COVID-19 for ≥ 28 days (US CDC Definition). We assessed the association of having had vs not had COVID-19 with measures as well as the association of 'long COVID' with these measures in unadjusted and adjusted models. We performed a subgroup analysis restricted to patients with RA. <h3>Results:</h3> We analyzed 276 post-COVID-19 cases and 59 comparators without COVID-19; 39.5% cases had 'long COVID' (Table 1). Most cases and comparators, respectively, had RA (67% and 85%), were female (80% and 80%), and White (88% and 93%). The most used medications were methotrexate and/or TNF inhibitors. RAPID-3, MHAQ, SF-12 physical and mental health, FSI, and SF-MPQ scores were similar among those with and without a history of COVID-19; rheumatic disease control was worse after COVID-19 infection among those with prior COVID-19 (Table 2). After stratifying by 'long COVID' status, worse RAPID-3 (3.7 vs 2.3, p&lt;0.01), MHAQ (0.4 vs 0.1, p&lt;0.01), SF-12 physical (38.1 vs 47.2, p&lt;0.01) and mental health (48.6 vs 53.0, p=0.03), FSI (5 vs 4 (p&lt;0.01), SF-MPQ scores for sensory (4.5 vs 3, p&lt;0.01), affective (1 vs 1, p=0.01), and present pain (2 vs 1, p&lt;0.01), and rheumatic disease control scores (6 vs 7, p=0.05) were observed among those with vs without 'long COVID'. Of note, perceived rheumatic disease control prior to COVID-19 or testing was similar among those with 'long COVID', without 'long COVID', and no prior history of COVID-19. Those without 'long COVID' had similar outcomes compared to those with no history of COVID-19 except for rheumatic disease control which was worse among those without 'long COVID' (Table 2). Findings were similar when the analyses were limited to those with RA and adjusted for age, sex, and race. <h3>Conclusion:</h3> In the post-acute period, COVID-19 has a substantial impact on people with inflammatory arthritis. Those with 'long COVID' have significantly worse rheumatic disease activity, disability, fatigue, pain, and quality of life. Even those who do not have 'long COVID' report worse disease control than those without prior COVID-19. These differences may reflect features of 'long COVID' and/or exacerbations of the underlying inflammatory arthritis. Additional studies are needed to elucidate the immunologic or other factors driving these differences. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Zachary S. Wallace Viela Bio, Zenas BioPharma, Horizon Therapeutics, Sanofi, MedPace, BioCryst, Amgen, PPD, Shionogi, Otsuka/Visterra, BMS, Sanofi, Amgen, Miao Lin: None declared, Xiaosong Wang: None declared, Naomi Patel: None declared, Yumeko Kawano: None declared, Abigail Schiff: None declared, Andrew King: None declared, Jennifer Hanberg: None declared, Shruthi Srivatsan: None declared, Emily Kowalski: None declared, Colebrook Johnson: None declared, Kathleen Vanni: None declared, Zachary Williams: None declared, Grace Qian: None declared, Caleb Bolden: None declared, Kevin Mueller: None declared, Katarina Bade: None declared, Alene Saavedra: None declared, Rathnam Venkat: None declared, Jeffrey A. Sparks AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, Pfizer, ReCor, Sobi, and UCB, BMS, Boehringer Ingelheim.