Naslov
How the covid-19 pandemic has influenced pediatric rheumatology practice: results of a global, cross-sectional, online survey

Autori
Batu, Ezgi Denis ; Lamot, Lovro ; Sag, Erdal ; Ozen, Seza ; Uziel, Yosef

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Pediatric Rheumatology, Vol. 18, Suppl. 2 (2020) / - London : Delhi : BioMed Central, 2020, 47-48

Skup
26th Paediatric Rheumatology European Society (PReS)

Mjesto i datum
Online, 23.09.2020. - 25.09.2020

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
COVID-19 ; pediatric rheumatology ; survey

Sažetak
Introduction: The COVID-19 (coronavirus disease 2019) pandemic is a global health problem threatening millions of lives worldwide. As pediatric rheumatologists, we have a role in the multidisciplinary management of COVID-19. Our young patients with rheumatic dis- eases are a vulnerable population in this pandemic. Moreover, the drugs we use to treat rheumatic diseases are being tested for use against COVID-19. Objectives: To analyze how the COVID-19 pandemic has affected pediatric rheumatology practice. Methods: For this cross-sectional survey study, we developed an on- line, self-administered survey that included 18 questions regarding changes in pediatric rheumatology practice due to the COVID-19 pandemic. Results were analyzed using descriptive statistics. Results: Worldwide, 271 pediatric rheumatologists (54% ≥45 years ; 65.7% female) from 60 countries responded to the survey in May 2020. Almost 70% of the respondents were practicing in a university hospital. 221 (81.5%) had been in pediatric rheumatology practice for ≥5 years. Nearly two-thirds of the respondents disagreed that the COVID-19 pandemic had led to reduced prescription of nonsteroidal anti-inflammatory drugs, conventional synthetic disease- modifying anti-rheumatic drugs (DMARDs), and biologic DMARDs. 220 (81.8%) did not change the management of patients who are using biologic DMARDs. Around 10% of the respondents were more inclined to pre- scribe hydroxychloroquine, while 237 (87.5%) did not report any change in their attitude towards prescribing this drug. Interestingly, 117 (43.2%) were more likely to taper corticosteroids faster. Most re- spondents reported that during the pandemic they hesitated to initi- ate treatment with cyclophosphamide (36.2%), followed by rituximab (25%). About half of the respondents cancelled scheduled appoint- ments with established patients and shifted towards smartphone applications for patient care, while 40% postponed clinic appoint- ments with new patients and used video consultations instead. Approximately one-third of respondents indicated that their patients had experienced a delay in the diagnosis of a rheumatic disease or in receiving an intraarticular steroid injection, while 56 (20.7%) stated that their patients experienced a flare due to delayed clinical ap- pointments. 97 (35.8%) mentioned that their patients had difficulties in obtaining hydroxychloroquine due to shortages and 30 (11%) noted the same problem with tocilizumab. Almost half of the respon- dents (n=120 ; 44.3%) think that children on long-term corticosteroid treatment should avoid attending school, while 51 (18.9%) believe that children using biologic DMARDs should avoid school ; especially those using rituximab (n=103 ; 38%). The respondents indicated that they had seen increases in the numbers of patients with Kawasaki disease (25.5%), macrophage activation syndrome (13.3%), unusual vasculitic rashes (28%), and hyperinflammation (22.5%), since the beginning of the COVID-19 pandemic. Conclusion: The COVID-19 pandemic has affected pediatric rheuma- tology practice extensively. Most changes arose from delays in clinic appointments, use of anti-rheumatic drugs in COVID-19 treatment/ prophylaxis and concerns about the immunosuppressive effects of anti-rheumatic therapies. In addition, an increase in the use of virtual technologies for routine communication with patients was observed.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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