As COVID-19 continues to spread, a recent study sought to investigate how those with spondyloarthritis (SpA) are impacted by the pandemic, as well as by social distancing measures and stay-at-home orders. The study focused specifically on the impact of pandemic-related home confinement on disease activity, treatment modifications, level of physical activity, and mental health.
The researchers administered a survey to 609 members of a private social network of the “Association Contre les Spondylarthrites” (ACS) to gather data and track changes in NSAID and biologic medication use, disease activity and flare onset, and infections during the COVID–19 pandemic. The survey revealed that 63% of participants reported an overall worsening of their disease during home confinement, with 28% experiencing a “considerable deterioration.” Worsening of symptoms was strongly associated with medication modifications. Other contributing factors included the reduction of physical activity due to home confinement. Exercise is especially important in SpA and helpful in reducing disease activity; COVID-19 social distancing measures played a significant factor in SpA patients reporting a reduction in physical activity in this survey.
Furthermore, 47% of patients reported medication modifications (either stopping, or reducing one or more medications) in light of COVID-19, with the majority of these modifications being seen in those taking NSAIDs regularly (39% having stopped or reduced their NSAID intake.) The authors attribute the high rate of NSAID modification to the fear of NSAIDs potentially worsening COVID-19. There was much early confusion surrounding the safety of NSAIDs for those who contract COVID-19, with some mixed warnings and recommendations being released at the start of the pandemic. This led to confusion for both patients and clinicians, and widespread uncertainty on the safety of NSAID use during this time. (The American College of Rheumatology recently released their guideline recommendations for treatment of rheumatic diseases throughout the COVID-19 pandemic, supporting the continued use of NSAID medications in most cases, with the exception of those with severe respiratory symptoms caused by COVID-19.)
Findings from the survey highlight the significant negative impacts that the COVID-19 pandemic and the subsequent social distancing have had on those with SpA. However, due to limitations of the study, it is difficult to say whether these negative impacts and worsening of disease severity were linked to enforced home-confinement, chronic stress and the psychological impacts of this situation, or the suspension or reduction of NSAIDs or other medications.
To further address these and other questions, the Spondylitis Association of America is conducting its own COVID-19 research to assess the impact spondyloarthritis, and medications used for spondyloarthritis, may have on COVID-19. The study is still ongoing and more than 3,000 people have participated in the web-based survey. The bottom line: the survey has found no evidence that biologics like TNF or IL-17 inhibitors, NSAIDs, or medications like methotrexate increase the risk of contracting COVID-19 or the risk of developing more severe COVID-19 infection. This is, of course, still preliminary as the survey is still ongoing. We encourage you to take part if you haven’t yet, and thank all of those who have contributed to this important research!
You can find more resources on COVID-19 and spondyloarthritis on our COVID-19 Resource Page.
With many public restrictions still in place, it is important that our community continues to find creative ways to stay active, in order to foster physical and mental wellbeing. Below are resources to help you stay healthy at home during these unprecedented times. SAA members can access our “Back in Action, Again” exercise series designed to instruct our spondyloarthritis community in exercise options. The exercises and stretches in this program were designed with common spondyloarthritis issues in mind. In addition, you can access our FREE Sample Exercise Flyer, to help guide you in incorporating simple stretches and workouts from the comfort of your own home.
Please remember that you are not alone. We invite you to reach out to a local Support Group (groups currently meeting virtually) where you can receive information and peer support in a confidential and friendly setting. Please reach out to one of our caring support group leaders and join your local community from the comfort of your home.
Lastly, please don’t hesitate to reach out to our caring staff at programs@spondylitis.org if we can be of help!
Full Article: https://onlinelibrary.wiley.com/doi/epdf/10.1002/art.41397
References:
Barnard, Claire. “COVID-19 Lockdown Has ‘Significant Consequences’ for SpA Patients.” Rheumatology.medicinematters.com, 21 July 2020, rheumatology.medicinematters.com/covid-19/infection/lockdown-significant-consequences-spa-patients/18126518.
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