From the Journals

Shielding ‘had little effect on rates of COVID-19 in rheumatology patients’


 

Researchers from the Royal Wolverhampton (England) Hospitals National Health Service Trust say shielding – or taking extra steps to protect oneself against COVID-19 if at high risk – has had little effect on the incidence of COVID-19 in rheumatology patients.

In Annals of the Rheumatic Diseases, the team present data from a large rheumatology cohort in the United Kingdom between Feb. 1, 2020, and May 1, 2020. Patients’ health-related quality of life (HRQoL) was assessed on April 24, 2020, using the Short Form–12 to assess Physical Component Score (PCS) and Mental Component Score (MCS) on a 0-100 scale (0 being the lowest score).

Of 1,693 participants, at the time, there were 61 (3.6%) reported COVID-19 infections (eight had confirmatory swab results; three had clinical diagnoses with “false-negative” swab; 50 had clinical diagnosis but were not swabbed in line with U.K. policy at that time).

Seven of the 61 (11.5%) patients were hospitalized, two requiring intensive care. Of this group, 24 were shielding, a similar proportion to the non-COVID cohort (24/61 vs. 768/1,632; P = .24). There was no significant effect of treatment on self-reported COVID-19 incidence.

There were significantly lower MCSs in the infected group, compared with control participants (38.9 vs. 42.2; mean difference: −3.3; 95% CI, −5.2 to 1.4; P < .001). There was no difference in PCS (−0.4; 95% CI, −2.1 to 1.3).

In patients without COVID-19, the ‘shielding’ group had significantly lower MCS (−2.1; 95% CI, −2.9 to 1.4; P < .001) and PCS (−2.2; 95% CI, −3.8 to 2.5; P < .001) than those not shielding.

There were no differences in MCSs between patients on non–biologic disease-modifying antirheumatic drugs and biologic DMARDs (0.6; 95% CI, 0.1-2.4).

The findings suggest that overall strict social isolation had little effect on the incidence of COVID-19 infection. Patients who had suffered from the virus had reduced mental but not physical HRQoL scores.

There was an adverse effect on both MCS and PCS reported by patients undergoing shielding,n compared with those not. This has also been shown in previous work from India.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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