COVID-19 on patients with immune-mediated rheumatic disease: a comparative study of disease activity, fatigue, and psychological distress over six months
Abstract Objectives To compare the impact of COVID-19 on the clinical status and psychological distress of patients with immune-mediated rheumatic disease (IMRD) caused by SARS-CoV-2 infection with that of noninfected IMRD controls during a 6-month follow-up period. Methods The ReumaCoV Brazil is a...
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BMC
2025-01-01
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| Series: | Advances in Rheumatology |
| Online Access: | https://doi.org/10.1186/s42358-025-00434-x |
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| author | Claudia Marques Marcelo M. Pinheiro Jennifer Lopes Sandra Lúcia Euzébio Ribeiro Mary Vânia Marinho de Castro Lilian David de Azevedo Valadares Aline Ranzolin Nicole Pamplona Bueno de Andrade Rafaela Cavalheiro do Espírito Santo Nafice Costa Araújo Cintya Martins Vieira Valéria Valim Flavia Patricia Sena Teixeira Santos Laurindo Ferreira da Rocha Adriana Maria Kakehasi Ana Paula Monteiro Gomides Reis Edgard Torres dos Reis-Neto Gecilmara Salviato Pileggi Gilda Aparecida Ferreira Licia Maria Henrique da Mota Odirlei Monticielo Ricardo Machado Xavier |
| author_facet | Claudia Marques Marcelo M. Pinheiro Jennifer Lopes Sandra Lúcia Euzébio Ribeiro Mary Vânia Marinho de Castro Lilian David de Azevedo Valadares Aline Ranzolin Nicole Pamplona Bueno de Andrade Rafaela Cavalheiro do Espírito Santo Nafice Costa Araújo Cintya Martins Vieira Valéria Valim Flavia Patricia Sena Teixeira Santos Laurindo Ferreira da Rocha Adriana Maria Kakehasi Ana Paula Monteiro Gomides Reis Edgard Torres dos Reis-Neto Gecilmara Salviato Pileggi Gilda Aparecida Ferreira Licia Maria Henrique da Mota Odirlei Monticielo Ricardo Machado Xavier |
| author_sort | Claudia Marques |
| collection | DOAJ |
| description | Abstract Objectives To compare the impact of COVID-19 on the clinical status and psychological distress of patients with immune-mediated rheumatic disease (IMRD) caused by SARS-CoV-2 infection with that of noninfected IMRD controls during a 6-month follow-up period. Methods The ReumaCoV Brazil is a longitudinal study designed to follow IMRD patients for 6 months after COVID-19 (patients) compared with IMRD patients without COVID-19 (controls). Clinical data, disease activity measurements and current treatments regarding IMRD and COVID-19 outcomes were evaluated in all patients. Disease activity was assessed through validated tools at inclusion and at 3 and 6 months post-COVID-19. Fatigue, using FACIT-F (Functional Assessment of Chronic Illness Therapy) and psychological distress, using DASS 21 (Depression, Anxiety and Stress Scale − 21 Items), used to evaluated psychological distress, were evaluated at 6 months after COVID-19 in both groups. The significance level was set as p < 0.05, with a 95% confidence interval. Results A total of 601 patients were evaluated—321 patients (IMRD COVID-19 + patients) and 280 controls (IMRD COVID-19- patients)—who were predominantly female with similar median ages. Disease activity assessment over a 6-month follow-up showed no significant difference between cases and controls. Although the mean activity scores did not differ significantly, some patients reported worsened disease activity post-COVID-19, particularly in rheumatoid arthritis (RA) (32.2%) and systemic lupus erythematosus (SLE) patients (23.3%). Post-COVID-19 worsening in RA patients correlated with medical global assessment (MGA) and CDAI scores, with a moderate to large effect size. Diabetes mellitus showed a positive association (OR = 7.15), while TNF inhibitors had a protective effect (OR = 0.51). Fatigue, depression, anxiety, and stress were significantly greater in patients than in controls. Worse disease activity post-COVID-19 correlated with worse FACIT-F and DASS-21 scores in RA patients. No significant associations were found between COVID-19 outcomes and post-COVID-19 disease activity, FACIT-F or DASS-21. Conclusions Post-COVID-19 IMRD patients exhibited significant fatigue, depression, anxiety, and stress, which can be mistaken for disease activity, despite having similar disease activity scores. The variability in reports on IMRD flares and the potential triggering of SARS-CoV-2 for autoimmune manifestations underscore the need for detailed clinical assessment and a comprehensive approach to managing them. |
| format | Article |
| id | doaj-art-7ede1463b504400b8395b2fc1450fcaa |
| institution | Kabale University |
| issn | 2523-3106 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Advances in Rheumatology |
| spelling | doaj-art-7ede1463b504400b8395b2fc1450fcaa2025-01-26T12:58:24ZengBMCAdvances in Rheumatology2523-31062025-01-0165111210.1186/s42358-025-00434-xCOVID-19 on patients with immune-mediated rheumatic disease: a comparative study of disease activity, fatigue, and psychological distress over six monthsClaudia Marques0Marcelo M. Pinheiro1Jennifer Lopes2Sandra Lúcia Euzébio Ribeiro3Mary Vânia Marinho de Castro4Lilian David de Azevedo Valadares5Aline Ranzolin6Nicole Pamplona Bueno de Andrade7Rafaela Cavalheiro do Espírito Santo8Nafice Costa Araújo9Cintya Martins Vieira10Valéria Valim11Flavia Patricia Sena Teixeira Santos12Laurindo Ferreira da Rocha13Adriana Maria Kakehasi14Ana Paula Monteiro Gomides Reis15Edgard Torres dos Reis-Neto16Gecilmara Salviato Pileggi17Gilda Aparecida Ferreira18Licia Maria Henrique da Mota19Odirlei Monticielo20Ricardo Machado Xavier21Department of Rheumatology, Hospital das Clínicas da Universidade Federal de Pernambuco/EbserhDepartment of Rheumatology, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP)Postgraduate Program of Translacional Health, Universidade Federal de PernambucoDepartment of Rheumatology, Faculdade de Medicina da Universidade Federal do AmazonasDepartment of Rheumatology, Faculdade de Medicina da Universidade Federal do AmazonasDepartment of Internal Medicine, Hospital Getúlio VargasDepartment of Internal Medicine, Hospital Getúlio VargasDepartment of Rheumatology, Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do SulDepartment of Rheumatology, Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do SulDepartment of Rheumatology, Hospital do Servidor Público Estadual de São Paulo - Instituto de Assistência Médica ao Servidor Público EstadualDepartment of Rheumatology, Hospital Universitário da Universidade Federal de Juiz de ForaDepartment of Rheumatology, Universidade Federal de SergipeDepartment of Rheumatology, Hospital das Clínicas - Universidade Federal de Minas GeraisDepartment of Rheumatology, Instituto de Medicina Integral Professor Fernando FigueiraDepartment of Rheumatology, Hospital das Clínicas - Universidade Federal de Minas GeraisDepartment of Rheumatology, Centro Universitário de BrasíliaDepartment of Rheumatology, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP)Department of Rheumatology, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP)Department of Rheumatology, Hospital das Clínicas - Universidade Federal de Minas GeraisDepartment of Rheumatology, Universidade de BrasíliaDepartment of Rheumatology, Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do SulDepartment of Rheumatology, Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do SulAbstract Objectives To compare the impact of COVID-19 on the clinical status and psychological distress of patients with immune-mediated rheumatic disease (IMRD) caused by SARS-CoV-2 infection with that of noninfected IMRD controls during a 6-month follow-up period. Methods The ReumaCoV Brazil is a longitudinal study designed to follow IMRD patients for 6 months after COVID-19 (patients) compared with IMRD patients without COVID-19 (controls). Clinical data, disease activity measurements and current treatments regarding IMRD and COVID-19 outcomes were evaluated in all patients. Disease activity was assessed through validated tools at inclusion and at 3 and 6 months post-COVID-19. Fatigue, using FACIT-F (Functional Assessment of Chronic Illness Therapy) and psychological distress, using DASS 21 (Depression, Anxiety and Stress Scale − 21 Items), used to evaluated psychological distress, were evaluated at 6 months after COVID-19 in both groups. The significance level was set as p < 0.05, with a 95% confidence interval. Results A total of 601 patients were evaluated—321 patients (IMRD COVID-19 + patients) and 280 controls (IMRD COVID-19- patients)—who were predominantly female with similar median ages. Disease activity assessment over a 6-month follow-up showed no significant difference between cases and controls. Although the mean activity scores did not differ significantly, some patients reported worsened disease activity post-COVID-19, particularly in rheumatoid arthritis (RA) (32.2%) and systemic lupus erythematosus (SLE) patients (23.3%). Post-COVID-19 worsening in RA patients correlated with medical global assessment (MGA) and CDAI scores, with a moderate to large effect size. Diabetes mellitus showed a positive association (OR = 7.15), while TNF inhibitors had a protective effect (OR = 0.51). Fatigue, depression, anxiety, and stress were significantly greater in patients than in controls. Worse disease activity post-COVID-19 correlated with worse FACIT-F and DASS-21 scores in RA patients. No significant associations were found between COVID-19 outcomes and post-COVID-19 disease activity, FACIT-F or DASS-21. Conclusions Post-COVID-19 IMRD patients exhibited significant fatigue, depression, anxiety, and stress, which can be mistaken for disease activity, despite having similar disease activity scores. The variability in reports on IMRD flares and the potential triggering of SARS-CoV-2 for autoimmune manifestations underscore the need for detailed clinical assessment and a comprehensive approach to managing them.https://doi.org/10.1186/s42358-025-00434-x |
| spellingShingle | Claudia Marques Marcelo M. Pinheiro Jennifer Lopes Sandra Lúcia Euzébio Ribeiro Mary Vânia Marinho de Castro Lilian David de Azevedo Valadares Aline Ranzolin Nicole Pamplona Bueno de Andrade Rafaela Cavalheiro do Espírito Santo Nafice Costa Araújo Cintya Martins Vieira Valéria Valim Flavia Patricia Sena Teixeira Santos Laurindo Ferreira da Rocha Adriana Maria Kakehasi Ana Paula Monteiro Gomides Reis Edgard Torres dos Reis-Neto Gecilmara Salviato Pileggi Gilda Aparecida Ferreira Licia Maria Henrique da Mota Odirlei Monticielo Ricardo Machado Xavier COVID-19 on patients with immune-mediated rheumatic disease: a comparative study of disease activity, fatigue, and psychological distress over six months Advances in Rheumatology |
| title | COVID-19 on patients with immune-mediated rheumatic disease: a comparative study of disease activity, fatigue, and psychological distress over six months |
| title_full | COVID-19 on patients with immune-mediated rheumatic disease: a comparative study of disease activity, fatigue, and psychological distress over six months |
| title_fullStr | COVID-19 on patients with immune-mediated rheumatic disease: a comparative study of disease activity, fatigue, and psychological distress over six months |
| title_full_unstemmed | COVID-19 on patients with immune-mediated rheumatic disease: a comparative study of disease activity, fatigue, and psychological distress over six months |
| title_short | COVID-19 on patients with immune-mediated rheumatic disease: a comparative study of disease activity, fatigue, and psychological distress over six months |
| title_sort | covid 19 on patients with immune mediated rheumatic disease a comparative study of disease activity fatigue and psychological distress over six months |
| url | https://doi.org/10.1186/s42358-025-00434-x |
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