The Open Rheumatology Journal




ISSN: ― Volume ,
RESEARCH ARTICLE

Self-Reported Symptoms in a Cohort of Rheumatoid Arthritis and Systemic Lupus Erythematosus during the COVID-19 Quarantine Period



Evelyn O. Salido1, Cherica A. Tee1, Patrick W. C. Reyes2, Heizel B. M. Reyes1, Geraldine T. Zamora1, Michael L. Tee1, *
1 College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila1000, Philippines
2 School of Statistics, University of the Philippines Diliman, Quezon City1101, Philippines

Abstract

Background:

During the first three months of the COVID-19 pandemic in the Philippines, there was a supply shortage of hydroxychloroquine and methotrexate. Limited access to medication and the life changes resulting from the COVID-19 pandemic may predispose patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) to disease flares.

Objective:

This study aimed to investigate self-reported symptoms of disease flares among patients with rheumatoid arthritis or systemic lupus erythematosus during the COVID-19 pandemic.

Methods:

A total of 512 completed online surveys from patients with SLE or RA were collected. The data included sociodemographic characteristics, self-reported physical symptoms, health service utilization, and availability of hydroxychloroquine and methotrexate.

Results:

Seventy-nine percent of respondents had lupus, while 21% had RA. One-third of the cohort had contact with their attending physician during the two-month quarantine period prior to the survey. Eighty-two percent were prescribed hydroxychloroquine and 23.4% were prescribed methotrexate; but 68.6% and 65%, respectively, had “irregular” intake of these medicines due to unavailability. The current health status was reported as good by 66.2%; 24% had no symptoms during the two-week period prior to the survey. The most common symptoms experienced were joint pain (51%), muscle pain (35%), headache (26.8%), and skin rash (19.1%). Five percent had a combination of these four most common symptoms. Irregular supply of hydroxychloroquine among patients with SLE (n=323) was associated with more frequent occurrence of muscle pain (40.6% vs 27.9%, p=0.03) or rash (27.4% vs 11.7%, p<0.001). Irregular supply of methotrexate among RA patients prescribed hydroxychloroquine and methotrexate (n=36) was associated with more frequent occurrence of joint pains with or without swelling (73.9% vs 38.5%, p=0.04). Irregular supply of hydroxychloroquine was associated with less frequent occurrence of dizziness (0 vs 66.7%, p<0.001) among RA patients (n=18).

Conclusion:

In our cohort of RA and SLE, the majority reported at least one symptom that may indicate disease flare. There was a significant association between the irregular supply of hydroxychloroquine or methotrexate with the presence of muscle pain, rash, or joint pains during the 14-day period prior to the survey.

Keywords: Self-report, Rheumatoid arthritis, Lupus, COVID-19, Hydroxychloroquine, Methotrexate.


Article Information


Identifiers and Pagination:

Year: 2021
Volume: 15
First Page: 16
Last Page: 23
Publisher Id: TORJ-15-16
DOI: 10.2174/1874312902115010016

Article History:

Received Date: 20/9/2020
Revision Received Date: 23/12/2020
Acceptance Date: 3/1/2021
Electronic publication date: 2/3/2021
Collection year: 2021

© 2021 Salido et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Correspondence: Address correspondence to this author at the College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines; E-mail: mltee@up.edu.ph



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