Shielding 'Had Little Effect on Rates of COVID-19 in Rheumatology Patients'

Dawn O'Shea

July 28, 2020

Researchers from the Royal Wolverhampton Hospitals NHS Trust say shielding has had little effect on the incidence of COVID-19 in rheumatology patients.

In Annals of Rheumatic Diseases, the team present data from a large rheumatology cohort in the UK between 1 February 2020 and 1 May 2020. Patients’ health-related quality of life (HRQoL) was assessed on 24 April 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 1693 participants, at the time, there were 61 (3.6%) reported COVID-19 infection (eight had confirmatory swab results; three had clinical diagnoses with ‘false-negative’ swab; 50 had clinical diagnosis but were not swabbed in line with UK policy at that time).

Seven of the 61 (11.5%) patients were hospitalised, two requiring intensive care. Of this group, 24 were shielding, a similar proportion to the non-COVID cohort (24/61 vs 768/1632; 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). The 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 (DMARDs) 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 when compared with those not. This has also been shown in previous work from India.

Cleaton N, Raizada S, Barkham N, Venkatachalam S, Sheeran T, Adizie T, Sapkota H, Singh B, Bateman J. COVID-19 prevalence and the impact on quality of life from stringent social distancing in a single large UK rheumatology centre. Ann Rheum Dis. 2020 Jul 21 [Epub ahead of print]. doi: 10.1136/annrheumdis-2020-218236 Full text.

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

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