A REDUCTION in NEW REFERRALS for RHEUMATOID ARTHRITIS, OSTEOARTHRITIS and CRYSTAL ARTHRITIS COMPARED to GCA during COVID19 PANDEMIC

ABSTRACT

Background: The COVID-19 pandemic has had profound effects on the Rheumatology department;we wanted to see if consequently referrals for Rheumatoid arthritis (RA), Crystal Arthritis (CA), Osteoarthritis (OA) and Giant cell arteritis (GCA) were affected. A greater understanding of the impact may enable adequate number of clinics and resources to be made available where needed. Objectives: To evaluate the impact of COVID-19 pandemic on volume of new referrals to the Rheumatology department for RA, CA, OA and GCA. Methods: A retrospective analysis of data was conducted from the period of January 2016 to December 2021. The Rheumatology department database was closely analysed and information about new referrals for GCA, RA, OA and CA were evaluated. Statistical analysis was conducted using t-test to compare the mean value pre and during the COVID19 outbreak (2020). Results: From 2016 to 2021 a total number of 9998 new patients were referred to the Rheumatology department. There were 2768 new referrals for GCA (15%), RA (34%), OA (40%) and CA (11%) made during this period. In 2020, there was a signifcant decrease in OA, RA and CA referrals (p value 0.000004, 0.00017, 0.0042 respectively) but an insignifcant decrease in GCA referrals (p value 0.243). Conclusion: During COVID19 pandemic in 2020 there was a signifcant reduction in the number of new referrals for RA, OA, and CA in contrast to GCA where the referrals have been constant. This may be due to the detrimental consequences of untreated GCA with regards to risk of sight loss. However, with less RA referrals, this may result in a delayed diagnosis with an impact on the disease course.