Functional and mental health affection (depression, anxiety, stress) among Egyptian rheumatic diseases patients during COVID-19 pandemic

R.M. El Khouly, H.M. Elsabagh, A.A.R. Moawad, S. Afifi, M.A. Abo El Hawa

Physical Medicine, Rheumatology and Rehabilitation, Public Health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt. h.elsabagh@mu.edu.sa

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• Infectious Diseases
• Psychiatry
• Rheumatology

OBJECTIVE: Psychological distress caused by the SARS-CoV-2 outbreak has had deleterious effects on patients with chronic rheumatic disease, as those patients were highly susceptible for COVID-19 infection due to their chronicity, in addition to use of immunosuppressive drugs. Therefore, they underwent to more isolation than other people and develop more stress and depression. This study aimed at evaluating level of depression, anxiety, stress symptoms and physical health status in Egyptian patients with various rheumatic diseases during COVID-19 pandemic.

PATIENTS AND METHODS: This is a cross-sectional study conducted in Gharbia Governorate, Egypt. It included 440 diagnosed cases of rheumatic diseases from 1st to the end of March 2021. Depression, Anxiety and Stress Scale-21 (DASS21) and RAPID3/MDHAQ test were used to assess the pandemic’s psychological and functional effect on participants.

RESULTS: RAPID3 test results showed that during the COVID-19 outbreak the 40% of patients had a moderate severity functional affection and 20% had high severity. DASS21 depression scoring showed mild to moderate depression (33% and 35%, respectively), while severe depression was detected in only 3.2% of cases. Moderate anxiety was reported in 49% of cases, 29% had severe anxiety while 1% showed extremely severe anxiety. Mild to moderate stress was reported in 17% and 16%, respectively. Female and cases aged more than 45 years had significantly more severe functional affection recorded by RAPID3 test, moderate stress and severe anxiety. On the other hand, severe depression was significantly higher in male and young patients younger than 45 years old.

CONCLUSIONS: Rheumatic disease patients have been highly susceptible to functional affection and psychological distress related to COVID-19 pandemic. Planning and implementation of programs to enforce coping strategies for these patients are required.

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