The impact of COVID-19 pandemic on rheumatology practice: a cross-sectional multinational study
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ORIGINAL ARTICLE
The impact of COVID-19 pandemic on rheumatology practice: a cross-sectional multinational study Nelly Ziadé 1 & Ihsane Hmamouchi 2 & Lina el Kibbi 3 & Nizar Abdulateef 4 & Hussein Halabi 5 & Fatemah Abutiban 6 & Wafa Hamdi 7 & Manal el Rakawi 8 & Mervat Eissa 9 & Basel Masri 10 Received: 3 August 2020 / Revised: 18 September 2020 / Accepted: 21 September 2020 # International League of Associations for Rheumatology (ILAR) 2020
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.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10067-020-05428-2) contains supplementary material, which is available to authorized users. * Nelly Ziadé [email protected]; [email protected] 1
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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
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