The psychological state of the patients with rheumatic diseases and hospital workers during the coronavirus disease (COVID-19) outbreak

Lisitsyna, T.; Veltishchev, D.; Borisova, A.; Nasonov, E.; Lila, A.

Background: Patients with rheumatic diseases are more likely to suffer from anxiety-depressive disorders and, in the context of the current coronavirus pandemic, are most likely to be more susceptible to stress response, depression, and anxiety. Objectives: to evaluate the frequency of anxiety-depressive symptoms and stress levels in patients with various rheumatic diseases (RD) and hospital workers of the Moscow Institute of Rheumatology in Russia Methods: 148 RD inpatients, mostly with rheumatoid arthritis (44 (30%)), spondyloarthritis (31 (21%)), systemic lupus erythematosus (28 (19%)), systemic sclerosis (10 (7%)), primary Sjögren syndrome (7 (5%)), polymyositis (6 (4%)), and 32 hospital workers of the Nasonova Research Institute of Rheumatology were screened using the DASS-21 (The Depression, Anxiety, Stress scales-21, Lovibond S.H. & Lovibond P.F. (1995)) in the period from July to November 2020. The majority of RD-patients and hospital workers were women (73 and 93% resp). The mean age (M±SD) of RD-patients and hospital workers was 43,2±16,2 and 40,7±14,6 years resp. Results: The frequency of depression (34,5% vs 34,4%), anxiety (41,9% vs 34,4%) and post-traumatic stress (27,7% vs 25,0%) in RD-patients were found to be comparable to that found among the hospital workers, and the level of anxiety was statistically significantly higher in patients (2,0 [1,0;6,0] vs 1,0 [0;4,5], p=0,038). There was no association of depression, anxiety and stress with RD activity. There was a weak positive correlation between the level of depression (R=0,30), anxiety (R=0,26) and stress (R=0,33) with a higher dose of glucocorticoids taken by patients, as well as a negative correlation between the severity of depression (R=-0,7) and stress (R=-0,17) with the age of patients and hospital workers. 19 (12,8%) of RD-patients and 7 (21,9%) of hospital workers had contracted COVID-19 in previous months. Survivors of the COVID-19, both among RD-patients and hospital workers, were more likely to experience symptoms of depression, anxiety and stress: accordingly, depression had 31,6% vs 27,9%, anxiety -47,4% vs 41,9% and stress -26,3% vs 28,7% RD-patients who had been ill or not, and among hospital workers: depression -28,6% vs 36,0%, anxiety -42,8% vs 28,0%, stress -42,8% vs 20,0%. 66,4% of RD-patients and 71,9% of hospital workers reported that the pandemic had a psychological impact on them. Conclusion: The COVID-19 pandemic has had and continues to have a significant negative psychological impact on both RD-patients and hospital workers. About 25-47% of patients and hospital workers experienced significant level of depression, anxiety and stress, and their frequency was higher in those who had contracted COVID-19.