Effect of COVID-19 pandemic on patients with rheumatoid arthritis, systemic lupus erythematosus

In the Philippines, in the early months of the COVID-19 pandemic, there occurred a supply shortage of hydroxychloroquine and methotrexate. Limited access to medication and the life changes caused from the COVID-19 pandemic may prompt patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) to experience disease flares.

The researchers investigated self-reported symptoms of disease flares among patients with rheumatoid arthritis or systemic lupus erythematosus during the COVID-19 pandemic. They collected information through online surveys from 512 patients with SLE or RA. The data included sociodemographic characteristics, self-reported physical symptoms, health service utilization, and availability of hydroxychloroquine and methotrexate.

From the data, 79% of respondents had lupus, while 21% had RA. One-third of the respondents had contact with their attending physician during the two-month quarantine period before the survey. 82% were prescribed hydroxychloroquine and 23.4% were prescribed methotrexate by the doctors, from which 68.6% and 65%, respectively, had "irregular" intake of these medicines due to lack of availability.

66.2% had good health status, 24% showed no symptoms during the two-week period prior to the survey. The most common symptoms experienced were joint pain, muscle pain, headache, and skin rash. 5% of the respondents had a combination of these four most common symptoms.

Irregular supply of hydroxychloroquine among patients with SLE was associated with more frequent appearance of muscle pain or rash. Irregular supply of methotrexate among RA patients prescribed hydroxychloroquine and methotrexate was linked with more frequent occurrence of joint pains with or without swelling. Irregular supply of hydroxychloroquine was associated with less frequent occurrence of dizziness in RA patients.

There was a significant association between the irregular supply of hydroxychloroquine or methotrexate with the presence of muscle pain, rash, or joint pains during the two weeks prior to the survey.