CHANGES in PATIENT-REPORTED OUTCOME SCORES during COVID-19 PANDEMIC: DATA from the ARTHRITISPOWER REGISTRY

ABSTRACT

Background: The COVID-19 pandemic causes concern among patients with autoimmune and rheumatic disease (ARD) due to increased risk of infection and heightened isolation from social distancing.1 Objectives: Examine how mean patient-reported outcome (PRO) scores for mental, social and physical health fuctuated after COVID-19 vaccine availability was widespread in US. Methods: We conducted and reported on2 an initial analysis of January 2020-April 2021 where US participants (pts) of the ArthritisPower (AP) registry completed PROMIS measures of physical health (Physical Function, Pain Interference, Fatigue, Sleep Disturbance), mental health (Anger, Anxiety, Depression) and social health (Social Isolation, Emotional Support). Follow-up analysis was conducted May-December 2021. Only pts from initial analysis were included in follow-up. Null hypothesis was no change in monthly average scores across 23-month pandemic period. Analysis of means compared monthly assessment mean scores to overall mean score for each measure during study period. Pts with < 2 assessment time points and osteoarthritis with no ARD were excluded from analysis. Results: Total of 49,940 PRO scores were contributed by 2,266 pts during 23-month period, with 8,393 of the scores contributed from May-December 2021. Mean (standard deviation, SD) number of observations per pt was 5.6 (12.5). Pts were 87.6% female, 86.7% white, mean age of 52.1 (12.7) years. Rheumatoid arthritis (n=1,131, 49.9%) was the most common condition. Most commonly reported measures were Pain Interference, Fatigue, Sleep Disturbance and Physical Function, each with >11,000 total results (Table 1). Pts' mental and social health assessment scores improved then worsened during last 8 months of 2021 (Figure 1). Overall mean scores were Anxiety 62.4 (12.5), Social Isolation 61.9 (10.5), and Anger 61.5 (12.8). From July-August, Social Isolation decreased by 1 SD. Compared to overall assessment mean, Anger declined by > / SD (53.3 [19.4]) in August and Anxiety declined by / SD (57.7 [11.3]) in September. By December, Anger rose by > / SD (68.6 [5.0]) of assessment mean. Pain Interference (mean 63.3 [7.8]), Fatigue (62.6 [9.5]), and Sleep Disturbance (58.1 [9.0]) scores were signifcantly lower in May, June, July and August compared to the assessment mean, though none decreased by > / SD. Conclusion: ARD members of AP had mental, social and physical health scores improve during summer of 2021, corresponding with widespread availability of vaccines. However mental and social health scores worsened by December as US faced new variants of the virus.