From the Department of Orthopedic Surgery.
J Clin Rheumatol. 2021 Apr 1;27(3):120-126. doi: 10.1097/RHU.0000000000001686.
The aim of this study was to assess patients' perceived risk of contracting SARS-CoV-2 at the peak of the pandemic in NYC in terms of their systemic rheumatic disease and medications.
With the approval of their rheumatologists, patients were interviewed by telephone and were asked about their perceived risk of contracting SARS-CoV-2 considering their rheumatic condition and whether medications increased this risk. Patients also completed surveys assessing beliefs about medication and multidimensions of physical/mental well-being. Information about current medications and rheumatologist-initiated changes in medications during the pandemic were reported by patients and verified from medical records.
One hundred twelve patients (86% women; mean age, 50 years; 81% White, 15% Latino) with diverse diagnoses were enrolled. Fifty-four percent thought they were at "very much greater risk" of COVID-19 because of their rheumatic condition, and 57% thought medications "definitely" put them at greater risk. In multivariable analysis, the perception of "very much greater risk" was associated with greater belief that rheumatic disease medications were necessary, worse physical function, chronic pulmonary comorbidity, and more anxiety. In a separate model, the perception that medications "definitely" caused greater risk was associated with White race, not taking hydroxychloroquine, rheumatologists initiating change in medications, more anxiety, and taking biologics and corticosteroids.
Patients' perceived increased risk of contracting SARS-CoV-2 was associated with beliefs about their rheumatic disease, medications, comorbidity, and anxiety. Clinicians should be aware of patients' perceptions and foster self-management practices that will alleviate anxiety, minimize exposure to the virus, and optimize systemic rheumatic disease outcomes.
本研究旨在评估纽约市大流行高峰期系统性风湿病患者及其药物治疗对 SARS-CoV-2 感染风险的认知。
在获得风湿病医生同意的情况下，通过电话对患者进行访谈，询问他们考虑到自身风湿病状况，感染 SARS-CoV-2 的风险，以及药物是否会增加这种风险。患者还完成了评估药物信念和身体/精神健康多维度的调查问卷。患者报告了当前药物治疗情况以及大流行期间风湿病医生启动的药物治疗改变情况，并通过病历进行核实。
共纳入 112 名患者（86%为女性；平均年龄 50 岁；81%为白人，15%为拉丁裔），诊断多样。54%的患者认为他们因自身的风湿病状况“风险极大”，57%的患者认为药物“肯定”会增加他们的风险。多变量分析显示，认为“风险极大”与认为风湿病药物有必要、身体功能更差、慢性肺部合并症以及焦虑程度更高相关。在另一个模型中，认为药物“肯定”会增加风险与白种人、未服用羟氯喹、风湿病医生启动药物治疗改变、焦虑程度更高以及使用生物制剂和皮质类固醇相关。
患者对感染 SARS-CoV-2 的风险感知增加与他们对风湿病、药物、合并症和焦虑的看法有关。临床医生应了解患者的看法，并促进自我管理实践，以减轻焦虑、减少病毒暴露，并优化系统性风湿病的治疗效果。
