Effects of the COVID-19 Pandemic in Unvaccinated Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis Patients Using Disease-modifying Antirheumatic Drugs

Objective: To investigate the health status, experiences, and status of contracting or being affected poorly by coronavirus disease-2019 (COVID-19) in patients using disease-modifying antirheumatic drugs (DMARD). Methods: Patients using DMARD for rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis registered in our rheumatic diseases outpatient clinic were assessed during their routine follow-up control between July 2020 and January 2021. Their health status between March and June 2020 was also registered in the first evaluation. A follow-up form was used in which demographic data, systemic diseases and drugs, rheumatic diseases and treatments, and changes in treatment and complaints during the pandemic period were questioned. Results: One hundred fifty six (95 female, 61 male) patients were included in the study, the mean age was 43.4. There was no relationship between age, gender, body mass index, occupation, rheumatic disease group, and DMARD groups, with conditions of getting or being affected severely by COVID-19. Statistically significant relationships were found between having a chronic respiratory disease or having more than one comorbid disease and severe COVID-19 outcomes and between having moderate/high rheumatic disease activity and contracting COVID-19 (p<0.05 for all). The rate of getting COVID-19 in smokers was significantly lower than in non-smokers (p=0.039). There was a significant increase in disease activity during the pandemic period compared with the pre-pandemic period (p<0.001). A statistically significant relationship was found between making changes for treating rheumatic disease and an increase in disease activity (p=0.003). Conclusion: Those with multiple comorbid diseases have an increased risk of severe COVID-19, and those with moderate-tohigh disease activity have an increased risk of developing COVID-19. The decrease in compliance with routine follow-up and drug treatment during the pandemic increases the risk of increased rheumatic disease activity.