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COVID-19 大流行对风湿病学实践的影响:一项跨国横断面研究。

The impact of COVID-19 pandemic on rheumatology practice: a cross-sectional multinational study.

机构信息

Hotel-Dieu de France Hospital, Saint-Joseph University, 6th floor, Tour des Consultations Externes, Alfred Naccache blvd. Achrafieh, Beirut, Lebanon.

Temara Hospital, Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.

出版信息

Clin Rheumatol. 2020 Nov;39(11):3205-3213. doi: 10.1007/s10067-020-05428-2. Epub 2020 Sep 30.

Abstract

OBJECTIVE

To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on rheumatology practice.

METHOD

A cross-sectional web survey was designed by the members of the Arab League of Associations for Rheumatology (ArLAR), validated by its scientific committee and disseminated through e-mail and social media. It included close-ended questions about the impact of the pandemic on the rheumatology activities, including outpatient visits and hospitalizations (in percentage, 100% corresponds to complete suspension) and open-ended questions about unmet needs. Univariate and multivariable logistic regression analyses were used to evaluate the predictors of impact. Suggestions were developed to improve the practice.

RESULTS

A total of 858 rheumatologists were included in the analysis (27.3% of registered in ArLAR), 37% were 35-44 years old, 60% were females, and 48% worked in the private sector. The impact of COVID-19 was a decrease of 69% in hospitalizations, 65% in outpatient clinic, 56% in infusion centers, and 43% in income. It was associated with the region (highest in the Gulf), use of telemedicine, impact on income and practice sector (lowest in private). There was a hydroxychloroquine shortage in 47%. Telemedicine was mostly based on traditional telephone contacts and e-mails and reimbursed in 12%. Fifteen rheumatologists (1.8%) were infected and 156 cases of COVID-19 were reported among patients. The top-cited unmet needs in rheumatology practice were access to drugs and a telemedicine platform.

CONCLUSIONS

The negative impact of the COVID-19 pandemic on rheumatology practice may compromise rheumatic diseases control. Better access to drugs and providing telemedicine platforms are recommended to improve the practice. Key Points • The COVID-19 pandemic had a significant negative impact on the rheumatology practice, including access to outpatient clinic, hospitalization, and to anchor drugs. • The compromised access to rheumatology care may jeopardize the control of chronic rheumatic diseases and the long-term prognosis. • Better access to drugs and providing telemedicine platforms are strongly recommended.

摘要

目的

评估 2019 年冠状病毒病(COVID-19)大流行对风湿病实践的影响。

方法

由阿拉伯联盟风湿病协会(ArLAR)成员设计了一项横断面网络调查,由其科学委员会进行验证,并通过电子邮件和社交媒体进行传播。它包括关于大流行对风湿病活动(包括门诊就诊和住院治疗,100%对应于完全暂停)影响的封闭式问题,以及关于未满足需求的开放式问题。采用单变量和多变量逻辑回归分析评估影响的预测因素。制定了改进实践的建议。

结果

共纳入 858 名风湿病医生进行分析(占 ArLAR 登记人数的 27.3%),37%的医生年龄在 35-44 岁之间,60%为女性,48%在私营部门工作。COVID-19 的影响是住院治疗下降 69%,门诊就诊下降 65%,输注中心下降 56%,收入下降 43%。它与地区(海湾地区最高)、远程医疗的使用、对收入和实践部门的影响(私营部门最低)有关。47%出现羟氯喹短缺。远程医疗主要基于传统电话联系和电子邮件,12%获得报销。有 15 名(1.8%)风湿病医生感染,有 156 例 COVID-19 患者报告。风湿病实践中被引用最多的未满足需求是获得药物和远程医疗平台。

结论

COVID-19 大流行对风湿病实践的负面影响可能会影响风湿性疾病的控制。建议更好地获得药物和提供远程医疗平台以改善实践。关键点:• COVID-19 大流行对风湿病实践产生了重大负面影响,包括获得门诊就诊、住院治疗和获得锚定药物。• 风湿病护理机会减少可能危及慢性风湿性疾病的控制和长期预后。• 强烈建议更好地获得药物和提供远程医疗平台。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ef2/7524572/78461bd9c990/10067_2020_5428_Fig1_HTML.jpg

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