Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK.
Rheumatology (Oxford). 2021 Feb 1;60(2):907-910. doi: 10.1093/rheumatology/keaa610.
The COVID-19 pandemic and the subsequent effects on healthcare systems is having a significant effect on the management of long-term autoimmune conditions. The aim of this study was to assess the problems faced by patients with idiopathic inflammatory myopathies (IIM).
An anonymized eSurvey was carried out with a focus on effects on disease control, continuity of medical care, drug procurance and prevalent fears in the patient population.
Of the 608 participants (81.1% female, median (s.d.) age 57 (13.9) years), dermatomyositis was the most frequent subtype (247, 40.6%). Patients reported health-related problems attributable to the COVID-19 pandemic (n = 195, 32.1%); specifically 102 (52.3%) required increase in medicines, and 35 (18%) required hospitalization for disease-related complications. Over half (52.7%) of the surveyed patients were receiving glucocorticoids and/or had underlying cardiovascular risk factors (53.8%), placing them at higher risk for severe COVID-19. Almost one in four patients faced hurdles in procuring medicines. Physiotherapy, critical in the management of IIM, was disrupted in 214 (35.2%). One quarter (159, 26.1%) experienced difficulty in contacting their specialist, and 30 (4.9%) were unable to do so. Most (69.6%) were supportive of the increased use of remote consultations to maintain continuity of medical care during the pandemic.
This large descriptive study suggests that the COVID-19 pandemic has incurred a detrimental effect on continuity of medical care for many patients with IIM. There is concern that delays and omissions in clinical care may potentially translate to poorer outcomes in the future.
新冠疫情及其对医疗系统的后续影响正在对长期自身免疫性疾病的管理产生重大影响。本研究旨在评估特发性炎性肌病（IIM）患者所面临的问题。
对患者进行了匿名电子调查，重点关注疾病控制、医疗连续性、药物采购以及患者群体中普遍存在的恐惧等方面的问题。
在 608 名参与者中（81.1%为女性，中位（标准差）年龄为 57 岁（13.9）），皮肌炎是最常见的亚型（247 例，40.6%）。患者报告了与新冠疫情相关的健康问题（n=195，32.1%）；具体而言，102 例（52.3%）需要增加药物，35 例（18%）因疾病相关并发症需要住院治疗。接受调查的患者中超过一半（52.7%）正在服用糖皮质激素和/或有潜在的心血管危险因素（53.8%），这使他们面临更高的感染新冠病毒后出现重症的风险。近四分之一（159 例，26.1%）的患者在购买药物时遇到困难。对 IIM 管理至关重要的物理治疗在 214 例（35.2%）中受到干扰。四分之一（159 例，26.1%）的患者在联系专科医生时遇到困难，而 30 例（4.9%）无法联系到。大多数（69.6%）患者支持在疫情期间增加远程咨询以保持医疗连续性。
这项大型描述性研究表明，新冠疫情对许多 IIM 患者的医疗连续性造成了不利影响。人们担心临床护理的延迟和疏漏可能会导致未来的结果恶化。
