The emergence of COVID-19 and the subsequent pandemic understandably brought about a surge in research directly related to the virus. Meanwhile, those living with chronic diseases risked being forgotten or overlooked by research at a time when key support and healthcare services became severely restricted due to lockdown. We decided to revisit three previous study populations in order to assess the impact of the pandemic and lockdown restrictions on their health, work and access to healthcare services.
What were we looking for?
We knew from previous studies that two key aspects of maintaining musculoskeletal health were taking regular exercise and maintaining good mental health; both of which we thought might be impacted by the pandemic. Exercise was likely to have been adversely affected by the lockdown conditions, and mental health was likely to have suffered due to a number of factors including anxiety around the pandemic generally, concerns about one’s own health, and the effects of social isolation caused by the amount of time required to be spent at home. Additionally, in the workplace many will have experienced drastic changes; some may still have been working in very stressful conditions, while others may have moved to home working, been furloughed or even lost their job.
What did we do?
We sent invites to three groups; people with axial spondyloarthritis (axSpA), people with psoriatic arthritis (PsA) and people living with chronic pain. We invited them to complete a short online questionnaire covering a range of topics including:
Their current health so we could assess how this had changed since we last contacted them
Their employment status, and how their employment was affected by the COVID-19 lockdown
Their experiences of accessing healthcare during lockdown, including changes to healthcare provision such as reduced services or the shift to virtual appointments
This paper reports on the first these – their health.
What did we find?
We received responses from 1054 people, with just under half (43%) returning their questionnaires in July 2020, and the rest responding after a reminder in August-September (25%) or October-December (32%).
Very few respondents reported they had had a confirmed COVID-19 diagnosis (only 1.6%), with just under 20% reporting they had either had, or were unsure if they had had, COVID-related symptoms. We need to remember though that this was at a time when few people with symptoms were being tested. The vast majority of people we surveyed reported they had had no COVID symptoms at all (75.2%).
When we compared the survey responses with previous questionnaires we found that there was a small, but significant, decrease in general quality of life, and this was primarily linked to poorer mental health and increased pain. We found a slight increase in symptoms associated with fibromyalgia (such as widespread pain, fatigue or trouble thinking), but sleep problems seemed to slightly decrease.
For those with specific conditions, we found that those with axSpA reported a slight worsening of their disease activity, while those with PsA indicated a decrease in quality of life linked with their illness, as well as slightly increased anxiety.
What does this mean?
On the one hand the study shows that there was a decrease in reported average quality of life during the lockdown period, mainly due to increased pain and anxiety. However, taken as a whole it is important to point out that the size of this increase was only small (if significant). This is generally reassuring, but it is important to note that addressing anxiety, plus providing additional support for self-management of pain, are likely to be important in future situations where normal health care services are unavailable.
