Impact of COVID-19 pandemic on rheumatoid arthritis from a Multi-Centre patient-reported questionnaire survey: influence of gender, rural-urban gap and north-south gradient.
Identifieur interne : 000913 ( Main/Curation ); précédent : 000912; suivant : 000914Impact of COVID-19 pandemic on rheumatoid arthritis from a Multi-Centre patient-reported questionnaire survey: influence of gender, rural-urban gap and north-south gradient.
Auteurs : Esam Abualfadl [Égypte] ; Faten Ismail [Égypte] ; Rawhya R El Shereef [Égypte] ; Eman Hassan [Égypte] ; Samar Tharwat [Égypte] ; Eman F. Mohamed [Égypte] ; Essam A. Abda [Égypte] ; Ahmed R. Radwan [Égypte] ; Rasha M. Fawzy [Égypte] ; Abdel Hafeez Moshrif [Égypte] ; Rasha Abdel Noor [Égypte] ; Soha Senara [Égypte] ; Mervat I Abd Elazim [Égypte] ; Nouran M. Abaza [Égypte] ; Hala A. Raafat [Égypte] ; Iman I. El-Gazzar [Égypte] ; Dina H. El-Hammady [Égypte] ; Nevin Hammam [Égypte, États-Unis] ; Tamer A. Gheita [Égypte] ; Reem El-Mallah [Égypte]Source :
- Rheumatology international [ 1437-160X ] ; 2021.
Descripteurs français
- KwdFr :
- Accessibilité des services de santé (statistiques et données numériques), Adulte (MeSH), Adulte d'âge moyen (MeSH), Disparités de l'état de santé (MeSH), Femelle (MeSH), Humains (MeSH), Mesures des résultats rapportés par les patients (MeSH), Mâle (MeSH), Pandémies (MeSH), Polyarthrite rhumatoïde (psychologie), Polyarthrite rhumatoïde (thérapie), Égypte (MeSH).
- MESH :
- psychologie : Polyarthrite rhumatoïde.
- statistiques et données numériques : Accessibilité des services de santé.
- thérapie : Polyarthrite rhumatoïde.
- Adulte, Adulte d'âge moyen, Disparités de l'état de santé, Femelle, Humains, Mesures des résultats rapportés par les patients, Mâle, Pandémies, Égypte.
- Wicri :
- geographic : Égypte.
English descriptors
- KwdEn :
- Adult (MeSH), Arthritis, Rheumatoid (psychology), Arthritis, Rheumatoid (therapy), COVID-19 (psychology), Egypt (MeSH), Female (MeSH), Health Services Accessibility (statistics & numerical data), Health Status Disparities (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Patient Reported Outcome Measures (MeSH), SARS-CoV-2 (MeSH).
- MESH :
- geographic : Egypt.
- psychology : Arthritis, Rheumatoid, COVID-19.
- statistics & numerical data : Health Services Accessibility.
- therapy : Arthritis, Rheumatoid.
- Adult, Female, Health Status Disparities, Humans, Male, Middle Aged, Pandemics, Patient Reported Outcome Measures, SARS-CoV-2.
Abstract
During the coronavirus disease-2019 (COVID-19) pandemic there were several barriers to treatment access and medication adherence in rheumatoid arthritis (RA) patients. There is no information regarding the RA patient health status in Egypt during the COVID-19. Thus,the aim of this work was to study the impact of the pandemic on RA patients through a patient-reported questionnaire and to determine the influence of gender, geographic regions. This multi-centre study initiated by the Egyptian College of Rheumatology (ECR) was conducted on 1037 RA patients attending rheumatology clinics from 10 governorates. The questionnaire provided covered socio-demographic data, health/disease status, information/knowledge about COVID-19 and medical/family history of the infection. Patients mean age was 44.2 ± 12.3 years;855 females and 182 males; 539(52%) from rural and 497(48%) from urban areas. 41.8% reported a striking difficulty to obtain hydroxychloroquine during the pandemic. The majority (70%) considered maintaining a regular visit to the rheumatologist in addition to remote contact mainly by phone (44.4%) or via WhatsApp (33.1%), in particular among male and urban patients. Urban patients were more likely to be infected by COVID-19 (12.9% vs 6.2%; p < 0.0001) than rural. Northern cities had more patients with suspected COVID-19 (13.9% vs 6.1%; p < 0.0001); was significantly associated with more disease flares (30.8% vs 5.8%) with subsequent change in the RA treatment (20.9% vs 6.4%; p < 0.0001). Patients with RA faced remarkable difficulty to obtain their medications with subsequent change in their disease status. The challenges of the pandemic have hastened changes in the way we deliver health care.
DOI: 10.1007/s00296-020-04736-9
PubMed: 33130920
PubMed Central: PMC7603433
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<author><name sortKey="Mohamed, Eman F" sort="Mohamed, Eman F" uniqKey="Mohamed E" first="Eman F" last="Mohamed">Eman F. Mohamed</name>
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<author><name sortKey="Abda, Essam A" sort="Abda, Essam A" uniqKey="Abda E" first="Essam A" last="Abda">Essam A. Abda</name>
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<author><name sortKey="Radwan, Ahmed R" sort="Radwan, Ahmed R" uniqKey="Radwan A" first="Ahmed R" last="Radwan">Ahmed R. Radwan</name>
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<author><name sortKey="Fawzy, Rasha M" sort="Fawzy, Rasha M" uniqKey="Fawzy R" first="Rasha M" last="Fawzy">Rasha M. Fawzy</name>
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<author><name sortKey="Moshrif, Abdel Hafeez" sort="Moshrif, Abdel Hafeez" uniqKey="Moshrif A" first="Abdel Hafeez" last="Moshrif">Abdel Hafeez Moshrif</name>
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<author><name sortKey="Noor, Rasha Abdel" sort="Noor, Rasha Abdel" uniqKey="Noor R" first="Rasha Abdel" last="Noor">Rasha Abdel Noor</name>
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<author><name sortKey="Elazim, Mervat I Abd" sort="Elazim, Mervat I Abd" uniqKey="Elazim M" first="Mervat I Abd" last="Elazim">Mervat I Abd Elazim</name>
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<author><name sortKey="Gheita, Tamer A" sort="Gheita, Tamer A" uniqKey="Gheita T" first="Tamer A" last="Gheita">Tamer A. Gheita</name>
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<author><name sortKey="El Mallah, Reem" sort="El Mallah, Reem" uniqKey="El Mallah R" first="Reem" last="El-Mallah">Reem El-Mallah</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Impact of COVID-19 pandemic on rheumatoid arthritis from a Multi-Centre patient-reported questionnaire survey: influence of gender, rural-urban gap and north-south gradient.</title>
<author><name sortKey="Abualfadl, Esam" sort="Abualfadl, Esam" uniqKey="Abualfadl E" first="Esam" last="Abualfadl">Esam Abualfadl</name>
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<author><name sortKey="Ismail, Faten" sort="Ismail, Faten" uniqKey="Ismail F" first="Faten" last="Ismail">Faten Ismail</name>
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<author><name sortKey="Shereef, Rawhya R El" sort="Shereef, Rawhya R El" uniqKey="Shereef R" first="Rawhya R El" last="Shereef">Rawhya R El Shereef</name>
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<country xml:lang="fr">Égypte</country>
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<author><name sortKey="Hassan, Eman" sort="Hassan, Eman" uniqKey="Hassan E" first="Eman" last="Hassan">Eman Hassan</name>
<affiliation wicri:level="1"><nlm:affiliation>Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria</wicri:regionArea>
</affiliation>
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<author><name sortKey="Tharwat, Samar" sort="Tharwat, Samar" uniqKey="Tharwat S" first="Samar" last="Tharwat">Samar Tharwat</name>
<affiliation wicri:level="1"><nlm:affiliation>Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Mansoura University, Dakahlia, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Mansoura University, Dakahlia</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Mohamed, Eman F" sort="Mohamed, Eman F" uniqKey="Mohamed E" first="Eman F" last="Mohamed">Eman F. Mohamed</name>
<affiliation wicri:level="1"><nlm:affiliation>Internal Medicine Department, Rheumatology Unit, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Internal Medicine Department, Rheumatology Unit, Faculty of Medicine (Girls), Al-Azhar University, Cairo</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Abda, Essam A" sort="Abda, Essam A" uniqKey="Abda E" first="Essam A" last="Abda">Essam A. Abda</name>
<affiliation wicri:level="1"><nlm:affiliation>Rheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Rheumatology Department, Faculty of Medicine, Assiut University, Assiut</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Radwan, Ahmed R" sort="Radwan, Ahmed R" uniqKey="Radwan A" first="Ahmed R" last="Radwan">Ahmed R. Radwan</name>
<affiliation wicri:level="1"><nlm:affiliation>Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Rheumatology Department, Faculty of Medicine, Sohag University, Sohag</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Fawzy, Rasha M" sort="Fawzy, Rasha M" uniqKey="Fawzy R" first="Rasha M" last="Fawzy">Rasha M. Fawzy</name>
<affiliation wicri:level="1"><nlm:affiliation>Rheumatology Department, Faculty of Medicine, Benha University, Kalyoubia, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Rheumatology Department, Faculty of Medicine, Benha University, Kalyoubia</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Moshrif, Abdel Hafeez" sort="Moshrif, Abdel Hafeez" uniqKey="Moshrif A" first="Abdel Hafeez" last="Moshrif">Abdel Hafeez Moshrif</name>
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<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assiut</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Noor, Rasha Abdel" sort="Noor, Rasha Abdel" uniqKey="Noor R" first="Rasha Abdel" last="Noor">Rasha Abdel Noor</name>
<affiliation wicri:level="1"><nlm:affiliation>Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Tanta University, Gharbia, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Tanta University, Gharbia</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Senara, Soha" sort="Senara, Soha" uniqKey="Senara S" first="Soha" last="Senara">Soha Senara</name>
<affiliation wicri:level="1"><nlm:affiliation>Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Elazim, Mervat I Abd" sort="Elazim, Mervat I Abd" uniqKey="Elazim M" first="Mervat I Abd" last="Elazim">Mervat I Abd Elazim</name>
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<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Abaza, Nouran M" sort="Abaza, Nouran M" uniqKey="Abaza N" first="Nouran M" last="Abaza">Nouran M. Abaza</name>
<affiliation wicri:level="1"><nlm:affiliation>Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Raafat, Hala A" sort="Raafat, Hala A" uniqKey="Raafat H" first="Hala A" last="Raafat">Hala A. Raafat</name>
<affiliation wicri:level="1"><nlm:affiliation>Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Rheumatology Department, Faculty of Medicine, Cairo University, Cairo</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="El Gazzar, Iman I" sort="El Gazzar, Iman I" uniqKey="El Gazzar I" first="Iman I" last="El-Gazzar">Iman I. El-Gazzar</name>
<affiliation wicri:level="1"><nlm:affiliation>Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Rheumatology Department, Faculty of Medicine, Cairo University, Cairo</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="El Hammady, Dina H" sort="El Hammady, Dina H" uniqKey="El Hammady D" first="Dina H" last="El-Hammady">Dina H. El-Hammady</name>
<affiliation wicri:level="1"><nlm:affiliation>Rheumatology Department, Faculty of Medicine, Helwan University, Cairo, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Rheumatology Department, Faculty of Medicine, Helwan University, Cairo</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Hammam, Nevin" sort="Hammam, Nevin" uniqKey="Hammam N" first="Nevin" last="Hammam">Nevin Hammam</name>
<affiliation wicri:level="1"><nlm:affiliation>Rheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Rheumatology Department, Faculty of Medicine, Assiut University, Assiut</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>Rheumatology Department, University of San Francisco, San Francisco, California, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Rheumatology Department, University of San Francisco, San Francisco, California</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Gheita, Tamer A" sort="Gheita, Tamer A" uniqKey="Gheita T" first="Tamer A" last="Gheita">Tamer A. Gheita</name>
<affiliation wicri:level="1"><nlm:affiliation>Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt. gheitamer@hotmail.com.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Rheumatology Department, Faculty of Medicine, Cairo University, Cairo</wicri:regionArea>
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<author><name sortKey="El Mallah, Reem" sort="El Mallah, Reem" uniqKey="El Mallah R" first="Reem" last="El-Mallah">Reem El-Mallah</name>
<affiliation wicri:level="1"><nlm:affiliation>Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
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<series><title level="j">Rheumatology international</title>
<idno type="eISSN">1437-160X</idno>
<imprint><date when="2021" type="published">2021</date>
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<term>Arthritis, Rheumatoid (psychology)</term>
<term>Arthritis, Rheumatoid (therapy)</term>
<term>COVID-19 (psychology)</term>
<term>Egypt (MeSH)</term>
<term>Female (MeSH)</term>
<term>Health Services Accessibility (statistics & numerical data)</term>
<term>Health Status Disparities (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Patient Reported Outcome Measures (MeSH)</term>
<term>SARS-CoV-2 (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Accessibilité des services de santé (statistiques et données numériques)</term>
<term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Disparités de l'état de santé (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Mesures des résultats rapportés par les patients (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Pandémies (MeSH)</term>
<term>Polyarthrite rhumatoïde (psychologie)</term>
<term>Polyarthrite rhumatoïde (thérapie)</term>
<term>Égypte (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="geographic" xml:lang="en"><term>Egypt</term>
</keywords>
<keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Polyarthrite rhumatoïde</term>
</keywords>
<keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Arthritis, Rheumatoid</term>
<term>COVID-19</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Health Services Accessibility</term>
</keywords>
<keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Accessibilité des services de santé</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Arthritis, Rheumatoid</term>
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<term>Patient Reported Outcome Measures</term>
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<front><div type="abstract" xml:lang="en">During the coronavirus disease-2019 (COVID-19) pandemic there were several barriers to treatment access and medication adherence in rheumatoid arthritis (RA) patients. There is no information regarding the RA patient health status in Egypt during the COVID-19. Thus,the aim of this work was to study the impact of the pandemic on RA patients through a patient-reported questionnaire and to determine the influence of gender, geographic regions. This multi-centre study initiated by the Egyptian College of Rheumatology (ECR) was conducted on 1037 RA patients attending rheumatology clinics from 10 governorates. The questionnaire provided covered socio-demographic data, health/disease status, information/knowledge about COVID-19 and medical/family history of the infection. Patients mean age was 44.2 ± 12.3 years;855 females and 182 males; 539(52%) from rural and 497(48%) from urban areas. 41.8% reported a striking difficulty to obtain hydroxychloroquine during the pandemic. The majority (70%) considered maintaining a regular visit to the rheumatologist in addition to remote contact mainly by phone (44.4%) or via WhatsApp (33.1%), in particular among male and urban patients. Urban patients were more likely to be infected by COVID-19 (12.9% vs 6.2%; p < 0.0001) than rural. Northern cities had more patients with suspected COVID-19 (13.9% vs 6.1%; p < 0.0001); was significantly associated with more disease flares (30.8% vs 5.8%) with subsequent change in the RA treatment (20.9% vs 6.4%; p < 0.0001). Patients with RA faced remarkable difficulty to obtain their medications with subsequent change in their disease status. The challenges of the pandemic have hastened changes in the way we deliver health care.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33130920</PMID>
<DateCompleted><Year>2021</Year>
<Month>02</Month>
<Day>04</Day>
</DateCompleted>
<DateRevised><Year>2021</Year>
<Month>02</Month>
<Day>04</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1437-160X</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>41</Volume>
<Issue>2</Issue>
<PubDate><Year>2021</Year>
<Month>02</Month>
</PubDate>
</JournalIssue>
<Title>Rheumatology international</Title>
<ISOAbbreviation>Rheumatol Int</ISOAbbreviation>
</Journal>
<ArticleTitle>Impact of COVID-19 pandemic on rheumatoid arthritis from a Multi-Centre patient-reported questionnaire survey: influence of gender, rural-urban gap and north-south gradient.</ArticleTitle>
<Pagination><MedlinePgn>345-353</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1007/s00296-020-04736-9</ELocationID>
<Abstract><AbstractText>During the coronavirus disease-2019 (COVID-19) pandemic there were several barriers to treatment access and medication adherence in rheumatoid arthritis (RA) patients. There is no information regarding the RA patient health status in Egypt during the COVID-19. Thus,the aim of this work was to study the impact of the pandemic on RA patients through a patient-reported questionnaire and to determine the influence of gender, geographic regions. This multi-centre study initiated by the Egyptian College of Rheumatology (ECR) was conducted on 1037 RA patients attending rheumatology clinics from 10 governorates. The questionnaire provided covered socio-demographic data, health/disease status, information/knowledge about COVID-19 and medical/family history of the infection. Patients mean age was 44.2 ± 12.3 years;855 females and 182 males; 539(52%) from rural and 497(48%) from urban areas. 41.8% reported a striking difficulty to obtain hydroxychloroquine during the pandemic. The majority (70%) considered maintaining a regular visit to the rheumatologist in addition to remote contact mainly by phone (44.4%) or via WhatsApp (33.1%), in particular among male and urban patients. Urban patients were more likely to be infected by COVID-19 (12.9% vs 6.2%; p < 0.0001) than rural. Northern cities had more patients with suspected COVID-19 (13.9% vs 6.1%; p < 0.0001); was significantly associated with more disease flares (30.8% vs 5.8%) with subsequent change in the RA treatment (20.9% vs 6.4%; p < 0.0001). Patients with RA faced remarkable difficulty to obtain their medications with subsequent change in their disease status. The challenges of the pandemic have hastened changes in the way we deliver health care.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Abualfadl</LastName>
<ForeName>Esam</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ismail</LastName>
<ForeName>Faten</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Shereef</LastName>
<ForeName>Rawhya R El</ForeName>
<Initials>RRE</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hassan</LastName>
<ForeName>Eman</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tharwat</LastName>
<ForeName>Samar</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Mansoura University, Dakahlia, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mohamed</LastName>
<ForeName>Eman F</ForeName>
<Initials>EF</Initials>
<AffiliationInfo><Affiliation>Internal Medicine Department, Rheumatology Unit, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Abda</LastName>
<ForeName>Essam A</ForeName>
<Initials>EA</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Radwan</LastName>
<ForeName>Ahmed R</ForeName>
<Initials>AR</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Fawzy</LastName>
<ForeName>Rasha M</ForeName>
<Initials>RM</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Benha University, Kalyoubia, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Moshrif</LastName>
<ForeName>Abdel Hafeez</ForeName>
<Initials>AH</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Noor</LastName>
<ForeName>Rasha Abdel</ForeName>
<Initials>RA</Initials>
<AffiliationInfo><Affiliation>Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Tanta University, Gharbia, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Senara</LastName>
<ForeName>Soha</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Elazim</LastName>
<ForeName>Mervat I Abd</ForeName>
<Initials>MIA</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Abaza</LastName>
<ForeName>Nouran M</ForeName>
<Initials>NM</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Raafat</LastName>
<ForeName>Hala A</ForeName>
<Initials>HA</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>El-Gazzar</LastName>
<ForeName>Iman I</ForeName>
<Initials>II</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>El-Hammady</LastName>
<ForeName>Dina H</ForeName>
<Initials>DH</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Helwan University, Cairo, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hammam</LastName>
<ForeName>Nevin</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Rheumatology Department, University of San Francisco, San Francisco, California, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Gheita</LastName>
<ForeName>Tamer A</ForeName>
<Initials>TA</Initials>
<Identifier Source="ORCID">0000-0002-1155-9729</Identifier>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt. gheitamer@hotmail.com.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>El-Mallah</LastName>
<ForeName>Reem</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><CollectiveName>ECR COVID19-Study Group</CollectiveName>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016448">Multicenter Study</PublicationType>
<PublicationType UI="D064888">Observational Study</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2020</Year>
<Month>11</Month>
<Day>01</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>Germany</Country>
<MedlineTA>Rheumatol Int</MedlineTA>
<NlmUniqueID>8206885</NlmUniqueID>
<ISSNLinking>0172-8172</ISSNLinking>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
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<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
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<MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004534" MajorTopicYN="N" Type="Geographic">Egypt</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006297" MajorTopicYN="N">Health Services Accessibility</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D054624" MajorTopicYN="Y">Health Status Disparities</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
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<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000071066" MajorTopicYN="Y">Patient Reported Outcome Measures</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Coronavirus Disease 2019 (COVID-19)</Keyword>
<Keyword MajorTopicYN="Y">Infection</Keyword>
<Keyword MajorTopicYN="Y">Multi-centre</Keyword>
<Keyword MajorTopicYN="Y">North-south gradient</Keyword>
<Keyword MajorTopicYN="Y">Patient-reported questionnaire</Keyword>
<Keyword MajorTopicYN="Y">Rheumatoid arthritis</Keyword>
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<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year>
<Month>09</Month>
<Day>23</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2020</Year>
<Month>10</Month>
<Day>19</Day>
</PubMedPubDate>
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<Month>11</Month>
<Day>2</Day>
<Hour>6</Hour>
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<Month>2</Month>
<Day>5</Day>
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