Background: The COVID-19 pandemic had a significant impact on
every aspect of life. Like other chronic
diseases, pediatric rheumatic diseases (PRDs) also faced unique
challenges during the pandemic, including limited access to care, concerns
regarding infection risk, drug shortages and social isolation. Objective: The objective of the study was to identify the impact of the COVID-19 pandemic
on the management course of children with rheumatic diseases. Methods: This cross-sectional study was conducted in the department
of paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from
April 2021 to March 2022. Two hundred and twenty patients were enrolled. A
predesigned questionnaire was completed which included socio-demographic,
clinical and laboratory parameters. Disease activity was assessed clinically
and from laboratory profile. Data were calculated manually and by using SPSS
version 22. Z-proportion test and chi square test were done when applicable. Results: Among the enrolled PRD cases 87.7% were Juvenile Idiopathic
Arthritis (JIA), 7.7% were Systemic Lupus Erythematosus (SLE) and 4.6% were
other cases. Irregular follow-ups were found in 69.9% JIA cases, 82.4% SLE
cases and 60% other PRD cases. Poor drug compliance was present in 18.2% of
cases. A significant number of patients had higher disease activity or flare
during the COVID-19 pandemic. Conclusion: During COVID-19 pandemic most
(70.5%) of the PRD patients were irregular in their follow-ups. Poor drug
compliance was also more than in the pre-COVID period. Disease activity status
significantly worsened during this period.
References
[1]
Jaung, W. (2021) Changes in Human-Nature Relations during Pandemic Outbreaks: A Big Data Analysis. Science of the Total Environment, 768, 144530-144537.
https://doi.org/10.1016/j.scitotenv.2020.144530
[2]
Sampath, S., Khedr, A., Qamar, S., et al. (2021) Pandemics throughout the History. Cureus, 13, 18136-18145. https://doi.org/10.7759/cureus.18136
[3]
Shang, Y., Li, H. and Zhang, R. (2021) Effects of Pandemic Outbreak on Economies: Evidence from Business History Context. Frontiers in Public Health, 9, Article ID: 632043. https://doi.org/10.3389/fpubh.2021.632043
[4]
Piot, P., Soka, M.J. and Spencer, J. (2019) Emergent Threats: Lessons Learnt from Ebola. International Health, 11, 334-337. https://doi.org/10.1093/inthealth/ihz062
[5]
Van Kerkhove, M.D., Ryan, M.J. and Ghebreyesus, T.A. (2021) Preparing for “Disease X”. Science, 374, 377-378. https://doi.org/10.1126/science.abm7796
[6]
Karia, R., Gupta, I., Khandait, H., Yadav, A. and Yadav, A. (2020) COVID-19 and Its Modes of Transmission. SN Comprehensive Clinical Medicine, 2, 1798-1801.
https://doi.org/10.1007/s42399-020-00498-4
[7]
Patrick, S.W., Henkhaus, L.E., Zickafoose, J.S., et al. (2020) Well-Being of Parents and Children during the COVID-19 Pandemic: A National Survey. Pediatrics, 146, e2020016824-32. https://doi.org/10.1542/peds.2020-016824
[8]
Ciurea, A., Papagiannoulis, E., Bürki, K., et al. (2021) Impact of the COVID-19 Pandemic on the Disease Course of Patients with Inflammatory Rheumatic Diseases: Results from the Swiss Clinical Quality Management Cohort. Annals of the Rheumatic Diseases, 80, 238-241.
https://doi.org/10.1136/annrheumdis-2020-218705
[9]
Kumar, A. and Nayar, K.R. (2020) COVID-19 and Its Mental Health Consequences. Journal of Mental Health, 30, 1-2. https://doi.org/10.1080/09638237.2020.1757052
[10]
Kretchy, I.A., Asiedu-Danso, M. and Kretchy, J.P. (2021) Medication Management and Adherence during the COVID-19 Pandemic: Perspectives and Experiences from Low- and Middle-Income Countries. Research in Social and Administrative Pharmacy, 17, 2023-2026. https://doi.org/10.1016/j.sapharm.2020.04.007
[11]
Stachteas, P., Symvoulakis, M., Tsapas, A. and Smyrnakis, E. (2022) The Impact of the COVID-19 Pandemic on the Management of Patients with Chronic Diseases in Primary Health Care. Population Medicine, 4, Article No. 23.
https://doi.org/10.18332/popmed/152606
[12]
George, M.D., Venkatachalam, S., Banerjee, S., et al. (2021) Concerns, Healthcare Use, and Treatment Interruptions in Patients with Common Autoimmune Rheumatic Diseases during the COVID-19 Pandemic. The Journal of Rheumatology, 48, 603-607. https://doi.org/10.3899/jrheum.201017
[13]
Dvergsten, J.A., Morgan, E. and Rabinovich, C.E. (2020) Treatment of Rheumatic Diseases. In: Nelson Textbook of Pediatrics, 21st Edition, Elsevier, Philadelphia, 1252-1257.
[14]
Kabir, M.H., Laila, K., Haque, M. and Rahman, S.A. (2017) Drug Compliance in Children with Juvenile Idiopathic Arthritis and Reasons for Poor Compliance. American Journal of Clinical and Experimental Medicine, 5, 15-18.
https://doi.org/10.11648/j.ajcem.20170501.14
[15]
Consolaro, A., Giancane, G., Schiappapietra, B., et al. (2016) Clinical Outcome Measures in Juvenile Idiopathic Arthritis. Pediatric Rheumatology, 14, Article No. 23. https://doi.org/10.1186/s12969-016-0085-5
[16]
Wallace, C.A., Ruperto, N. and Giannini, E. (2004) Preliminary Criteria for Clinical Remission for Select Categories of Juvenile Idiopathic Arthritis. The Journal of Rheumatology, 31, 2290-2294.
[17]
Gladman, D.D., Ibanez, D. and Urowitz, M.B. (2002) Systemic Lupus Erythematosus Disease Activity Index 2000. The Journal of Rheumatology, 29, 288-291.
[18]
Huber, A.M., Feldman, B.M., Rennebohm, R.M., et al. (2004) Validation and Clinical Significance of the Childhood Myositis Assessment Scale for Assessment of Muscle Function in the Juvenile Idiopathic Inflammatory Myopathies. Arthritis & Rheumatology, 50, 1595-1603. https://doi.org/10.1002/art.20179
[19]
Becker, M.O., Dobrota, R., Garaiman, A., et al. (2022) Development and Validation of a Patient-Reported Outcome Measure for Systemic Sclerosis: The EULAR Systemic Sclerosis Impact of Disease (ScleroID) Questionnaire. Annals of the Rheumatic Diseases, 81, 507-515. https://doi.org/10.1136/annrheumdis-2021-220702
[20]
Islam, M.I., Sonia, S.P., Haque, M., et al. (2022) Disease Activity States of Juvenile Idiopathic Arthritis in a Referral Centre in Bangladesh. Bangladesh Medical Research Council Bulletin, 48, 41-47. https://doi.org/10.3329/bmrcb.v48i1.60659
[21]
Rahman, M.M., Laila, K. and Rahman, S.A. (2022) Efficacy and Safety of Tofacitinib in the Treatment of Refractory Cases of Polyarticular Course Juvenile Idiopathic Arthritis: A Study from Bangladesh. International Journal of Rheumatic Diseases, 25, 678-684. https://doi.org/10.1111/1756-185X.14324
[22]
Hegde, A., Acharya, S., Singh, K. and Kovilapu, U.B. (2020) Clinical Profile of Juvenile Idiopathic Arthritis from a Tertiary Care Hospital in Northern India. Indian Journal of Rheumatology, 15, 310-316. https://doi.org/10.4103/injr.injr_137_20
[23]
Tanya, M., Teh, K.L., Das, L., Hoh, S.F., Gao, X. and Arkachaisri, T. (2020) Juvenile Idiopathic Arthritis in Southeast Asia: The Singapore Experience over Two Decades. Clinical Rheumatology, 39, 3455-3464.
https://doi.org/10.1007/s10067-020-05081-9
[24]
Cardoso, I., Frederiksen, P., Specht, I.O., et al. (2021) Age and Sex Specific Trends in Incidence of Juvenile Idiopathic Arthritis in Danish Birth Cohorts from 1992 to 2002: A Nationwide Register Linkage Study. International Journal of Environmental Research and Public Health, 18, 8331-8338. https://doi.org/10.3390/ijerph18168331
[25]
Petty, R.E., Laxer, R.M. and Wedderburn, L.R. (2016) Classification Criteria for JIA. In: Petty, R.E., Laxer, R.M., Lindsley, C.B. and Wedderburn, L.R., Eds., Textbook of Paediatric Rheumatology, 7th Edition, Elsevier Saunders, Philadelphia, 189.
[26]
Chigwedere, O.C., Sadath, A., Kabir, Z. and Arensman, E. (2021) The Impact of Epidemics and Pandemics on the Mental Health of Healthcare Workers: A Systematic Review. International Journal of Environmental Research and Public Health, 18, 6695-6730. https://doi.org/10.3390/ijerph18136695
[27]
Chudasama, Y.V., Gillies, C.L., Zaccardi, F., et al. (2020) Impact of COVID-19 on Routine Care for Chronic Diseases: A Global Survey of Views from Healthcare Professionals. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14, 965-967. https://doi.org/10.1016/j.dsx.2020.06.042
[28]
Ziadé, N., Hmamouchi, I., Kibbi, L., et al. (2020) The Impact of COVID-19 Pandemic on Rheumatology Practice: A Cross-Sectional Multinational Study. Clinical Rheumatology, 39, 3205-3213. https://doi.org/10.1007/s10067-020-05428-2
[29]
Fernández-ávila, D.G., Barahona-Correa, J., Romero-Alvernia, D., et al. (2022) Impact of COVID-19 Pandemic on Patients with Rheumatic Diseases in Latin America. Rheumatology International, 42, 41-49.
https://doi.org/10.1007/s00296-021-05014-y
[30]
Saqib, M.A.N., Siddiqui, S., Qasim, M., et al. (2020) Effect of COVID-19 Lockdown on Patients with Chronic Diseases. Diabetology & Metabolic Syndrome, 14, 1621-1623. https://doi.org/10.1016/j.dsx.2020.08.028
[31]
Antonelli, A., Fallahi, P., Elia, G., et al. (2021) Effect of the COVID-19 Pandemic on Patients with Systemic Rheumatic Diseases. The Lancet Rheumatology, 3, e675-e676. https://doi.org/10.1016/S2665-9913(21)00243-5
[32]
Coskun, B.N., Yagiz, B., Pehlivan, Y. and Dalkilic, E. (2021) Attitudes of Patients with a Rheumatic Disease on Drug Use in the COVID-19 Pandemic. Advances in Rheumatology, 61, 211-216. https://doi.org/10.1186/s42358-021-00211-6
[33]
Hassen, L.M., Almaghlouth, I.A., Hassen, I.M., et al. (2020) Impact of COVID-19 Outbreak on Rheumatic Patients’ Perceptions and Behaviors: A Cross-Sectional Study. International Journal of Rheumatic Diseases, 23, 1541-1549.
https://doi.org/10.1111/1756-185X.13959
[34]
Batu, E.D., Lamot, L., Sag, E., Ozen, S. and Uziel, Y. (2020) How the COVID-19 Pandemic Has Influenced Pediatric Rheumatology Practice: Results of a Global, Cross-Sectional, Online Survey. Seminars in Arthritis and Rheumatism, 50, 1262-1268. https://doi.org/10.1016/j.semarthrit.2020.09.008
[35]
Dushnicky, M.J., Campbell, C., Beattie, K.A., et al. (2022) Impact of the COVID-19 Pandemic on Juvenile Idiopathic Arthritis Presentation and Research Recruitment: Results from the CAPRI Registry. Rheumatology (Oxford), 61, SI157-SI162.
https://doi.org/10.1093/rheumatology/keab812
