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1.
Expert Rev Mol Med ; 24: e13, 2022 03 15.
Article in English | MEDLINE | ID: covidwho-1751544

ABSTRACT

Coronavirus disease 2019 (COVID-19) is associated with autoimmunity and systemic inflammation. Patients with autoimmune rheumatic and musculoskeletal disease (RMD) may be at high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this review, based on evidence from the literature, as well as international scientific recommendations, we review the relationships between COVID-19, autoimmunity and patients with autoimmune RMDs, as well as the basics of a multisystemic inflammatory syndrome associated with COVID-19. We discuss the repurposing of pharmaceutics used to treat RMDs, the principles for the treatment of patients with autoimmune RMDs during the pandemic and the main aspects of vaccination against SARS-CoV-2 in autoimmune RMD patients.


Subject(s)
COVID-19 , Musculoskeletal Diseases , Autoimmunity , COVID-19/complications , COVID-19/drug therapy , Humans , Inflammation , Musculoskeletal Diseases/therapy , SARS-CoV-2
2.
Work ; 71(3): 493-503, 2022.
Article in English | MEDLINE | ID: covidwho-1731738

ABSTRACT

BACKGROUND: Musculoskeletal disorders are a significant public health issue that negatively affects individuals and society both socially and economically, and increases the cost of care and cure. OBJECTIVE: This study aimed to determine the musculoskeletal problems and risk factors of academicians who transitioned to provide distance education during the COVID-19 pandemic. METHODS: The population of this descriptive cross-sectional study included academicians who worked in two public universities in Turkey. Ethical committee approval and institutional permissions were obtained between 1 and 28 February 2021. Data were collected using a personal information form, the Work Environment Evaluation Questionnaire, and the Musculoskeletal Pain Intensity Assessment Questionnaire. The data were analyzed using the number, percentage, independent group t-test, ANOVA test, and linear regression analysis (forward method). The analysis was interpreted at the 95% confidence level and 0.05 error margin. RESULTS: Of the academicians, 78% were women, 54.6% were married, 80.6% did not regularly exercise, and 73.5% had more workload during the distance education period. Academicians mostly experienced discomfort about their eyes, necks, and waists, and an increase at a significant level was detected in their musculoskeletal system problems during the distance education period. Increasing workload, duration of mobile phone use, active time, having an ergonomic chair, and gender predicted the musculoskeletal system pain intensity by 20%. CONCLUSION: Musculoskeletal system problems are a significant public health issue. Academicians should be informed and consulted for the protection of musculoskeletal system health during the distance education period.


Subject(s)
COVID-19 , Education, Distance , Musculoskeletal Diseases , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Musculoskeletal Diseases/epidemiology , Musculoskeletal Diseases/etiology , Pandemics , Surveys and Questionnaires
3.
J Manipulative Physiol Ther ; 44(7): 558-565, 2021 09.
Article in English | MEDLINE | ID: covidwho-1720447

ABSTRACT

OBJECTIVE: The purpose of this scoping review was to identify information about telehealth and rehabilitation for the evaluation and management of musculoskeletal disorders, patient satisfaction, cost, and access as may be applicable during the COVID-19 pandemic. METHODS: We searched MEDLINE for studies published between January 1, 2000, and June 1, 2019. Search terms consisted of MEDLINE medical subject headings and other words relevant to this review, including "telerehabilitation," "musculoskeletal," "telemedicine," "therapy," "chiropractic," "ergonomics," and "exercise." This review targeted studies of people aged 18 years and older with musculoskeletal concerns. Articles on diagnostic tests, effectiveness of treatment, patient satisfaction, access to care, and cost were included. RESULTS: Eleven studies were included in this review. Interrater reliability and agreement were moderate to high for several assessment procedures for the lower limb, elbow, and low back. Two clinical trials demonstrated that provider and patient simultaneous telehealth were equally as effective as in-office care. Patient and provider satisfaction with telehealth were reported to be equal to or higher than for conventional rehabilitation. We found no studies reporting cost or access. CONCLUSION: In the COVID-19 pandemic environment, telehealth is feasible for health care providers to provide rehabilitation services for their patients with various musculoskeletal conditions. Current evidence suggests that for some musculoskeletal disorders, telehealth evaluation may be reliable, treatment may be effective, and patient satisfaction may be good or better than for in-office care. Results from this study may help physiatry, physical therapy, and chiropractic health care providers in their decisions to implement telehealth during and after the COVID-19 pandemic.


Subject(s)
COVID-19 , Musculoskeletal Diseases , Telemedicine , Adolescent , Adult , COVID-19/epidemiology , Humans , Musculoskeletal Diseases/diagnosis , Musculoskeletal Diseases/therapy , Pandemics , Reproducibility of Results
5.
Work ; 71(2): 309-318, 2022.
Article in English | MEDLINE | ID: covidwho-1662551

ABSTRACT

BACKGROUND: The recent mandate for university faculty and staff to work-from-home (WFH) during the COVID-19 pandemic has forced employees to work with sub-optimal ergonomic workstations that may change their musculoskeletal discomfort and pain. As women report more work-related musculoskeletal discomfort (WMSD), this effect may be exacerbated in women. OBJECTIVE: The purpose of this study was to describe university employee at-home office workstations, and explore if at-home workstation design mediates the effect of gender on musculoskeletal pain. METHODS: University employees completed a survey that focused on the WFH environment, at home workstation design and musculoskeletal pain. Descriptive statistics and regression analysis were used to analyze the responses. RESULTS: 61% of respondents reported an increase in musculoskeletal pain, with the neck, shoulders and lower back being reported most frequently. Women reported significantly greater musculoskeletal pain, but this relationship was significantly mediated by poor ergonomic design of the home workstation. Improper seat-height and monitor distance were statistically associated with total-body WMSD. CONCLUSIONS: WFH has worsened employee musculoskeletal health and the ergonomic gap between women and men in the workspace has persisted in the WFH environment, with seat height and monitor distance being identified as significant predictors of discomfort/pain.


Subject(s)
COVID-19 , Musculoskeletal Diseases , Musculoskeletal Pain , Occupational Diseases , Ergonomics , Female , Humans , Male , Musculoskeletal Diseases/epidemiology , Musculoskeletal Diseases/etiology , Musculoskeletal Diseases/prevention & control , Musculoskeletal Pain/epidemiology , Musculoskeletal Pain/etiology , Musculoskeletal Pain/prevention & control , Occupational Diseases/epidemiology , Occupational Diseases/prevention & control , Pandemics , SARS-CoV-2
6.
Work ; 71(2): 395-405, 2022.
Article in English | MEDLINE | ID: covidwho-1662549

ABSTRACT

BACKGROUND: The imposition of telework by the COVID-19 pandemic represented a challenge for companies and workers with regard to the management and organization of the workplace at home. OBJECTIVES: To evaluate the ergonomic risks, psychosocial factors and musculoskeletal symptoms as well as the relationships between these variables in employees of a Brazilian labor judiciary unit. METHODS: A cross-sectional study was carried out with 55 employees who had their workstations evaluated by means of the Rapid Office Strain Assessment (ROSA-Br) and answered a questionnaire of sociodemographic and occupational characterization, the dimensions of workstation and posture of the Maastricht Upper Extremity Questionnaire (MUEQ-Br-revised), the short version of the Job Stress Scale and the Nordic Musculoskeletal Questionnaire (NMQ). RESULTS: The workstations evaluations by ROSA-Br and MUEQ-Br-revised showed a strong correlation between themselves and to body posture, but they were not related to the occurrence of musculoskeletal symptoms. Body posture and demands were correlated to each other and with to occurrence of musculoskeletal symptoms. Shoulders, neck and wrists / hands were the most affected body regions. CONCLUSIONS: Companies that adopt teleworking for their employees must be aware of working conditions at home, including the workload, and offer adequate support in order to prevent the occurrence of musculoskeletal problems.


Subject(s)
COVID-19 , Musculoskeletal Diseases , Occupational Diseases , Cross-Sectional Studies , Ergonomics , Humans , Musculoskeletal Diseases/epidemiology , Musculoskeletal Diseases/etiology , Musculoskeletal Diseases/prevention & control , Occupational Diseases/epidemiology , Occupational Diseases/prevention & control , Pandemics , Risk Factors , SARS-CoV-2 , Social Justice , Surveys and Questionnaires , Teleworking
7.
Work ; 71(1): 65-78, 2022.
Article in English | MEDLINE | ID: covidwho-1638137

ABSTRACT

BACKGROUND: The COVID-19 pandemic has increased some psychosocial risks which may aggravate the development of musculoskeletal disorders (MSDs) and reduced psychological well-being, two leading global occupational health problems. OBJECTIVE: This study aims to investigate whether an employee's psychological well-being mediates the relationship between the psychosocial factors (job strain, work-life balance, and job security) and the prevalence of musculoskeletal pain in the Indonesian general working population during the pandemic. METHODS: A cross-sectional study design was employed using an online questionnaire. A total of 406 from 465 respondents were included in the final analysis. RESULTS: It was found that 73.9% of respondents suffered from upper body part pain, 25.15% from low back pain, and 39.7% reported pain in the lower limb. Process Macro Model 4 analysis showed the significant role of well-being as a mediator in the association between work-life balance and the odds of experiencing the upper body and low back pains. However, neither the direct nor mediating effect on the relationship between job strain or job security and any musculoskeletal pains were observed. These findings suggest that specific psychosocial factors may be more relevant to be investigated in the particular context. CONCLUSION: The use of a mediation model was able to link work-life balance to musculoskeletal complaints through well-being states in the context of the pandemic. Organizations need to mitigate poor well-being triggered by psychosocial stressors which could affect physical complaints to maintain employee's health and productivity.


Subject(s)
COVID-19 , Musculoskeletal Diseases , Musculoskeletal Pain , Occupational Diseases , Cross-Sectional Studies , Humans , Musculoskeletal Diseases/complications , Musculoskeletal Diseases/epidemiology , Musculoskeletal Pain/epidemiology , Musculoskeletal Pain/etiology , Occupational Diseases/epidemiology , Pandemics , Risk Factors , SARS-CoV-2 , Surveys and Questionnaires
8.
Arthritis Res Ther ; 24(1): 21, 2022 01 11.
Article in English | MEDLINE | ID: covidwho-1623638

ABSTRACT

BACKGROUND: Little is known about the safety of SARS-CoV-2 vaccination in patients with rheumatic musculoskeletal disease (RMD). We evaluated the occurrence of adverse events following immunization (AEFI) in RMD patients and heathy subjects who received anti-SARS-CoV-2 mRNA vaccine. METHODS: We performed a telephone interview collecting any adverse event (AE) following immunization (AEFI) that occurred in RMD patients and healthy controls after the two doses of mRNA vaccine including common local reactogenicity and systemic events (for example, fever, fatigue/malaise, joint and muscle pain). We also investigated the onset of new signs or symptoms of the RMD after the vaccination. RESULTS: We evaluated 126 patients with RMDs [105 females and 19 males, median age 51(IQR 17)] and 85 controls [62 females and 23 males, (median age 49 (20)]. Seventy patients (55.6%) were taking immunosuppressants, conventional synthetic (n=31, 43.3%) and/or biological [TNF inhibitors (n=49, 68.6%)], and 30 (23.8%) were taking hydroxychloroquine; treatment remained unchanged in 77% of patients. Eleven out of 126 patients and none of the 85 controls previously contracted COVID-19. The median follow-up from the completion of vaccination was 15 (3) weeks both in patients and controls. We reviewed 5 suspected cases confirming mild articular flares in 3 women (2.8) with inflammatory arthritis (2 psoriatic arthritis and 1 rheumatoid arthritis) while no disease reactivation was recorded in patients with connective tissue diseases; the incidence rate of RMD reactivation was 0.007 person/month. Multivariable logistic regression analysis showed similar frequencies of local and systemic AEFI in patients and controls with no effect of therapies or previous COVID-19. Local reaction-pain in the injection site-was the most frequently reported AEFI both in RMD and controls (71% and 75% of all the AEFI, respectively) after the first dose. Overall, up to 66% of patients experienced at least one AEFI at the second dose and up to 62% in the control group. Most of AEFI occurred within 2 days of vaccine administration. Two RMD patients developed pauci-symptomatic COVID-19 after the first dose of vaccine. CONCLUSION: The low incidence rate of disease reactivation and the similar AEFI occurrence compared to controls should reassure on mRNA vaccine safety in RMD patients.


Subject(s)
COVID-19 , Musculoskeletal Diseases , Rheumatic Diseases , COVID-19 Vaccines , Female , Humans , Male , Middle Aged , Rheumatic Diseases/drug therapy , SARS-CoV-2 , Symptom Flare Up , Vaccines, Synthetic
9.
Int J Environ Res Public Health ; 18(24)2021 12 13.
Article in English | MEDLINE | ID: covidwho-1596216

ABSTRACT

Despite all its promises, telemedicine is still not widely implemented in the care of rheumatic and musculoskeletal diseases (RMDs). The aim of this study is to investigate opportunities, barriers, acceptance, and preferences concerning telemedicine among RMD patients and professional stakeholders. From November 2017 to December 2019, a participatory, mixed-methods study was conducted, consisting of (1) expert interviews (n = 27) with RMD patients and professional stakeholders, (2) a national paper-based patient survey (n = 766), and (3) focus groups (n = 2) with patient representatives and rheumatologists. The qualitative findings indicate that patients equate personal contact with physical face-to-face contact, which could be reduced by implementing telemedicine, thus negatively influencing the patient-doctor relationship. Correspondingly "no personal contact with the doctor" is the main reason (64%) why 38% of the surveyed patients refuse to try telemedicine. Professional stakeholders expect telemedicine to contribute to the effective allocation of scarce resources in rheumatology care. The main barriers reported by stakeholders were the scarcity of time resources in RMD care, the absence of physical examinations, and organizational challenges associated with the implementation of telemedicine in RMD care. While the exact integration of telemedicine into routine care has yet to be found, the consequences on the patient-physician relationship must be permanently considered.


Subject(s)
Musculoskeletal Diseases , Rheumatology , Telemedicine , Focus Groups , Humans , Surveys and Questionnaires
10.
Ann Rheum Dis ; 81(5): 695-709, 2022 May.
Article in English | MEDLINE | ID: covidwho-1595585

ABSTRACT

OBJECTIVES: To describe the safety of vaccines against SARS-CoV-2 in people with inflammatory/autoimmune rheumatic and musculoskeletal disease (I-RMD). METHODS: Physician-reported registry of I-RMD and non-inflammatory RMD (NI-RMDs) patients vaccinated against SARS-CoV-2. From 5 February 2021 to 27 July 2021, we collected data on demographics, vaccination, RMD diagnosis, disease activity, immunomodulatory/immunosuppressive treatments, flares, adverse events (AEs) and SARS-CoV-2 breakthrough infections. Data were analysed descriptively. RESULTS: The study included 5121 participants from 30 countries, 90% with I-RMDs (n=4604, 68% female, mean age 60.5 years) and 10% with NI-RMDs (n=517, 77% female, mean age 71.4). Inflammatory joint diseases (58%), connective tissue diseases (18%) and vasculitis (12%) were the most frequent diagnostic groups; 54% received conventional synthetic disease-modifying antirheumatic drugs (DMARDs), 42% biological DMARDs and 35% immunosuppressants. Most patients received the Pfizer/BioNTech vaccine (70%), 17% AstraZeneca/Oxford and 8% Moderna. In fully vaccinated cases, breakthrough infections were reported in 0.7% of I-RMD patients and 1.1% of NI-RMD patients. I-RMD flares were reported in 4.4% of cases (0.6% severe), 1.5% resulting in medication changes. AEs were reported in 37% of cases (37% I-RMD, 40% NI-RMD), serious AEs in 0.5% (0.4% I-RMD, 1.9% NI-RMD). CONCLUSION: The safety profiles of SARS-CoV-2 vaccines in patients with I-RMD was reassuring and comparable with patients with NI-RMDs. The majority of patients tolerated their vaccination well with rare reports of I-RMD flare and very rare reports of serious AEs. These findings should provide reassurance to rheumatologists and vaccine recipients and promote confidence in SARS-CoV-2 vaccine safety in I-RMD patients.


Subject(s)
Antirheumatic Agents , COVID-19 , Musculoskeletal Diseases , Rheumatic Diseases , Aged , Antirheumatic Agents/adverse effects , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Female , Humans , Immunosuppressive Agents/adverse effects , Male , Middle Aged , Muscular Diseases , Musculoskeletal Diseases/chemically induced , Musculoskeletal Diseases/drug therapy , Musculoskeletal Diseases/epidemiology , Registries , Rheumatic Diseases/drug therapy , Rheumatologists , SARS-CoV-2 , Vaccination/adverse effects
11.
Ann Rheum Dis ; 81(3): 422-432, 2022 03.
Article in English | MEDLINE | ID: covidwho-1560917

ABSTRACT

OBJECTIVES: Perform a systematic literature review (SLR) on risk and prognosis of SARS-CoV-2 infection and vaccination against SARS-CoV-2 in patients with rheumatic and musculoskeletal diseases (RMDs). METHODS: Literature was searched up to 31 May 2021, including (randomised) controlled trials and observational studies with patients with RMD. Pending quality assessment, data extraction was performed and risk of bias (RoB) was assessed. Quality assessment required provision of (1) an appropriate COVID-19 case definition, and (2a) a base incidence (for incidence data) or (2b) a comparator, >10 cases with the outcome and risk estimates minimally adjusted for age, sex and comorbidities (for risk factor data). RESULTS: Of 5165 records, 208 were included, of which 90 passed quality assessment and data were extracted for incidence (n=42), risk factor (n=42) or vaccination (n=14). Most studies had unclear/high RoB. Generally, patients with RMDs do not face more risk of contracting SARS-CoV-2 (n=26 studies) or worse prognosis of COVID-19 (n=14) than individuals without RMDs. No consistent differences in risk of developing (severe) COVID-19 were found between different RMDs (n=19). Disease activity is associated with worse COVID-19 prognosis (n=2), possibly explaining the increased risk seen for glucocorticoid use (n=13). Rituximab is associated with worse COVID-19 prognosis (n=7) and possibly Janus kinase inhibitors (n=3). Vaccination is generally immunogenic, though antibody responses are lower than in controls. Vaccine immunogenicity is negatively associated with older age, rituximab and mycophenolate. CONCLUSION: This SLR informed the July 2021 update of the European Alliance of Associations for Rheumatology recommendations for the management of RMDs in the context of SARS-CoV-2.


Subject(s)
COVID-19 Vaccines/immunology , COVID-19/mortality , Musculoskeletal Diseases/virology , Rheumatic Diseases/virology , SARS-CoV-2/immunology , Adult , COVID-19/immunology , COVID-19/prevention & control , Female , Glucocorticoids/adverse effects , Humans , Immunogenicity, Vaccine/drug effects , Immunosuppressive Agents/adverse effects , Incidence , Janus Kinase Inhibitors/adverse effects , Male , Middle Aged , Musculoskeletal Diseases/drug therapy , Prognosis , Rheumatic Diseases/drug therapy , Risk Factors , Rituximab/adverse effects
13.
BMC Public Health ; 21(1): 2076, 2021 11 12.
Article in English | MEDLINE | ID: covidwho-1526610

ABSTRACT

BACKGROUND: This study used surveillance data from 2018 and 2020 to test the stability of work-related strain symptoms (high stress, sleep deprivation, exhaustion) with demographic factors, work characteristics, and musculoskeletal symptoms among farm and ranch operators in seven midwestern states of the United States. METHODS: Cross-sectional surveys were conducted among farm and ranch operators in 2018 (n = 4423) and 2020 (n = 3492). Operators were asked whether, in the past 12 months, they experienced extended work periods that resulted in high stress levels, sleep deprivation, exhaustion/fatigue, or other work-related strain symptoms. Covariates included personal and demographic factors, work characteristics, number of injuries, work-related health conditions, and exposures on the operation. Summary statistics were tabulated for explanatory and outcome variables. The classification (decision) tree approach was used to assess what variables would best separate operators with and without reported strain symptoms, based on a set of explanatory variables. Regularized regression was used to generate effect estimates between the work strain variables and explanatory variables. RESULTS: High stress level, sleep deprivation, and exhaustion were reported more frequently in 2018 than 2020. The classification tree reproduced the 2018 model using 2020 data with approximately 80% accuracy. The mean number of reported MSD symptoms increased slightly from 1.23 in 2018 to 1.41 in 2020. Older age, more time spent in farm work, higher gross farm income (GFI), and MSD symptoms in six body regions (ankles/feet, knees, lower back, neck, shoulders, wrists/hands) were associated with all three work strain symptoms. CONCLUSIONS: Musculoskeletal pain and discomfort was a strong predictor for stress, sleep deprivation, and exhaustion among farmers and ranchers. This finding indicates that reducing MSD pain and discomfort is beneficial for both physical and mental health.


Subject(s)
Musculoskeletal Diseases , Occupational Diseases , Occupational Stress , Aged , Cross-Sectional Studies , Farmers , Farms , Humans , Midwestern United States/epidemiology , Risk Factors , Surveys and Questionnaires , United States/epidemiology
14.
JBJS Rev ; 9(7)2021 07 16.
Article in English | MEDLINE | ID: covidwho-1511874

ABSTRACT

¼: Telemedicine and remote care administered through technology are among the fastest growing sectors in health care. The utilization and implementation of virtual-care technologies have further been accelerated with the recent COVID-19 pandemic. ¼: Remote, technology-based patient care is not a "one-size-fits-all" solution for all medical and surgical conditions, as each condition presents unique hurdles, and no true consensus exists regarding the efficacy of telemedicine across surgical fields. ¼: When implementing virtual care in orthopaedics, as with standard in-person care, it is important to have a well-defined team structure with a deliberate team selection process. As always, a team with a shared vision for the care they provide as well as a supportive and incentivized environment are integral for the success of the virtual-care mechanism. ¼: Future studies should assess the impact of primarily virtual, integrated, and multidisciplinary team-based approaches and systems of care on patient outcomes, health-care expenditure, and patient satisfaction in the orthopaedic population.


Subject(s)
COVID-19 , Musculoskeletal Diseases/diagnosis , Musculoskeletal Diseases/therapy , Patient Care Team , Telemedicine , Humans
15.
Int Orthop ; 46(2): 189-195, 2022 02.
Article in English | MEDLINE | ID: covidwho-1499431

ABSTRACT

PURPOSE: To verify changes in the health-related quality of life (HRQOL) of patients with musculoskeletal disorders after the coronavirus disease 2019 (COVID-19) pandemic and to assess the relationship between the patients' change in several activities of daily living and in the HRQOL to discover factors related to the deterioration in HRQOL. METHODS: A multi-centre cross-sectional questionnaire survey was administered between November 1, 2020, and December 31, 2020, in Japan. The participants included those who visited the orthopaedics clinic within the survey period and had experienced the first and second waves of COVID-19 in Japan and the first stay-at-home order issued by the government. Patients' HRQOL at the two different time points (pre-outbreak and post-second wave of COVID-19) was assessed with the EuroQoL-5 dimensions 5-level (EQ-5D). RESULTS: The survey was completed by 1254 patients (average age: 52.5 ± 21.9 years; 644 women). Among them, 431 patients (34.3%) reported a decrease in the EQ-5D index after the pandemic. The largest decrease was in the pain domain followed by the mobility domain. Multivariate logistic regression analysis revealed that the patients with decreased regular exercise habits were significantly related to deterioration in HRQOL compared with those with stable regular exercise (adjusted odds ratio = 1.76, p < 0.001) independently from age, sex, and change of symptoms. CONCLUSIONS: Up to 35% of patients with musculoskeletal disorders reported deterioration of HRQOL after the COVID-19 pandemic. Pain and mobility rather than anxiety were the two leading factors of the HRQOL decrease. The decrease in regular exercise was related to the HRQOL decrease.


Subject(s)
COVID-19 , Musculoskeletal Diseases , Activities of Daily Living , Adult , Aged , Cross-Sectional Studies , Female , Humans , Middle Aged , Musculoskeletal Diseases/epidemiology , Pandemics , Quality of Life , SARS-CoV-2 , Surveys and Questionnaires
16.
Rheumatology (Oxford) ; 60(SI): SI13-SI24, 2021 10 09.
Article in English | MEDLINE | ID: covidwho-1493950

ABSTRACT

OBJECTIVE: To quantify the change in quality of life, disease-specific indicators, health and lifestyle before and during the COVID-19 pandemic among people with musculoskeletal diagnoses and symptoms. METHODS: We undertook an additional follow-up of two existing UK registers involving people with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) and participants in a trial in the UK who had regional pain and were identified at high risk of developing chronic widespread pain. Participants completed the study questionnaire between July and December 2020, throughout which time there were public health restrictions in place. RESULTS: The number of people taking part in the study was 1054 (596 axSpA, 162 PsA, 296 regional pain). In comparison with their previous (pre-pandemic) assessment, there was an age-adjusted significant, small decrease in quality of life measured by EQ-5D [-0.020 (95% CI -0.030, -0.009)] overall and across all population groups examined. This was primarily related to poorer mental health and pain. There was a small increase in fibromyalgia symptoms, but a small decrease in sleep problems. There was a small deterioration in axSpA disease activity, and disease-specific quality of life and anxiety in PsA participants. Predictors of poor quality of life were similar pre- and during the pandemic. The effect of lockdown on activity differed according to age, gender and deprivation. CONCLUSION: Important lessons include focusing on addressing anxiety and providing enhanced support for self-management in the absence of normal health care being available, and awareness that all population groups are likely to be affected.


Subject(s)
COVID-19 , Chronic Pain/psychology , Communicable Disease Control , Musculoskeletal Diseases/psychology , Quality of Life , Adult , Aged , Anxiety/epidemiology , Anxiety/etiology , Female , Follow-Up Studies , Health Services Accessibility , Humans , Male , Middle Aged , Patient Acceptance of Health Care/psychology , Registries , SARS-CoV-2 , United Kingdom/epidemiology
17.
Clin Rheumatol ; 41(1): 289-296, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1491164

ABSTRACT

OBJECTIVE: To document the detailed characteristics including severity, type, and locations of rheumatic and musculoskeletal symptoms along with other COVID-19 persistent symptoms in hospitalized COVID-19 survivors at 3 and 6 months. METHODS: In this extension cohort study, two telephone surveys at 3 and 6 months following the hospitalization were carried out. In these telephone surveys, participants were asked regarding their symptoms through a previously designed standard questionnaire. RESULTS: At 3 months, 89.0% of survivors had at least one symptom, 74.6% had at least one rheumatic and musculoskeletal symptom, and 82.1% had at least one other COVID-19 symptom. At 6 months, 59.6% of survivors had at least one symptom, 43.2% had at least one rheumatic and musculoskeletal symptom, and 51.2% had at least one other COVID-19 symptom. Regarding the rheumatic and musculoskeletal symptoms, 31.6% had fatigue, 18.6% had joint pain, and 15.1% had myalgia; and regarding the other-COVID-19-symptoms, 25.3% had dyspnea, 20.0% had hair loss, and 17.2% sweat at 6 months. In an adjusted model, female patients were more likely to have fatigue (OR: 1.99, 95% CI: 1.18-3.34), myalgia (3.00, 1.51-5.98), and joint pain (3.39, 1.78-6.50) at 6 months. CONCLUSION: Approximately 3 in 5 patients had at least one symptom with ≈2 in 5 patients had at least one rheumatic and musculoskeletal symptom. Fatigue, joint pain, and myalgia were the most frequent rheumatic and musculoskeletal symptoms. Joint pain and myalgia were mostly widespread. This information guide rheumatologists to understand the nature and features of persistent rheumatic and musculoskeletal symptoms in hospitalized COVID-19 survivors and may contribute to better management of these individuals. Key Points • Approximately 3 in 5 patients had at least one symptom with ≈2 in 5 patients had at least one rheumatic and musculoskeletal symptom at 6 months • Fatigue, joint pain, and myalgia were the most frequent rheumatic and musculoskeletal symptoms followed by back pain, low back pain, and neck pain • Dyspnea, hair loss, and sweat were the most frequent other-COVID-19-symptoms.


Subject(s)
COVID-19 , Musculoskeletal Diseases/virology , Rheumatic Diseases/virology , Arthralgia , COVID-19/complications , Cohort Studies , Fatigue , Female , Hospitalization , Humans , Myalgia , SARS-CoV-2 , Survivors
19.
Rheumatology (Oxford) ; 60(SI): SI77-SI84, 2021 10 09.
Article in English | MEDLINE | ID: covidwho-1462481

ABSTRACT

OBJECTIVES: During the COVID-19 pandemic, much communication occurred online, through social media. This study aimed to provide patient perspective data on how the COVID-19 pandemic impacted people with rheumatic and musculoskeletal diseases (RMDs), using Twitter-based patient-generated health data (PGHD). METHODS: A convenience sample of Twitter messages in English posted by people with RMDs was extracted between 1 March and 12 July 2020 and examined using thematic analysis. Included were Twitter messages that mentioned keywords and hashtags related to both COVID-19 (or SARS-CoV-2) and select RMDs. The RMDs monitored included inflammatory-driven (joint) conditions (ankylosing spondylitis, RA, PsA, lupus/SLE and gout). RESULTS: The analysis included 569 tweets by 375 Twitter users with RMDs across several countries. Eight themes emerged regarding the impact of the COVID-19 pandemic on people with RMDs: (i) lack of understanding of SARS-CoV-2/COVID-19; (ii) critical changes in health behaviour; (iii) challenges in healthcare practice and communication with healthcare professionals; (iv) difficulties with access to medical care; (v) negative impact on physical and mental health, coping strategies; (vi) issues around work participation; (vii) negative effects of the media; and (viii) awareness-raising. CONCLUSION: The findings show that Twitter serves as a real-time data source to understand the impact of the COVID-19 pandemic on people with RMDs. The platform provided 'early signals' of potentially critical health behaviour changes. Future epidemics might benefit from the real-time use of Twitter-based PGHD to identify emerging health needs, facilitate communication and inform clinical practice decisions.


Subject(s)
COVID-19/prevention & control , Musculoskeletal Diseases/psychology , Quarantine/psychology , Rheumatic Diseases/psychology , Social Media , Adaptation, Psychological , Communication , Health Behavior , Health Services Accessibility , Humans , SARS-CoV-2
20.
Arh Hig Rada Toksikol ; 72(3): 232-239, 2021 Sep 28.
Article in English | MEDLINE | ID: covidwho-1444010

ABSTRACT

One of the side-effects of the COVID-19 pandemic is a global change in work ergonomic patterns as millions of people replaced their usual work environment with home to limit the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection. The aim of our cross-sectional pilot study was to identify musculoskeletal pain that may have resulted from this change and included 232 telecommunications company workers of both genders [121 (52.2 %) men aged 23-62 (median 41; interquartile range 33-46 yrs.) and 111 (47.8 %) women aged 23-53 (median 40; interquartile range 33-44)] who had been working from home for eight months (from 16 March to 4 December 2020) before they joined the study. The participants were asked to fill in our web-based questionnaire by self-assessing their experience of hand, lower back, and upper back/neck pain while working at home and by describing their work setting and physical activity. Compared to previous work at the office, 90 (39.1 %) participants reported stronger pain in the lower back, 105 (45.7 %) in the upper back/neck, and 63 (27.2 %) in their hands. Only one third did not report any musculoskeletal problems related to work from home. Significantly fewer men than women reported hand, lower back, and upper back/ neck pain (p=0.033, p=0.001 and p=0.013, respectively). Sixty-nine workers (29.9 %) reported to work in a separate room, 75 (32.4 %) worked in a separate section of a room with other household members, whereas 87 (37.7 %) had no separate work space, 30 of whom most often worked in the dining room. Ninety-five participants (40.9 %) had no office desk to work at, and only 75 (32.3 %) used an ergonomic chair. Of those who shared their household with others (N=164), 116 (70.7 %) complained about constant or occasional disturbances. Over a half of all participants (52 %) said that they worked longer hours from home than at work, predominantly women (p=0.05). Only 69 participants (29.9 %) were taking frequent breaks, predominantly older ones (p=0.006). Our findings clearly point to a need to inform home workers how to make more ergonomic use of non-ergonomic equipment, use breaks, and exercise and to inform employers how to better organise working hours to meet the needs of work from home.


Subject(s)
COVID-19 , Musculoskeletal Diseases , Musculoskeletal Pain , Occupational Diseases , Telecommunications , Cross-Sectional Studies , Female , Humans , Male , Musculoskeletal Pain/epidemiology , Occupational Diseases/epidemiology , Pandemics , Pilot Projects , SARS-CoV-2 , Teleworking
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