Impact of COVID-19 inthepracticeofrheumatologists

Objectives: The COVID-19 pandemic has led to unexpected changes in rheumatology1, forcing physicians to implement telemedicine2 in order to prevent contagion, due to a limited access to personal protective equipment and the increased risk of rheumatology patients of contracting COVID-19 due to their underlying diseases or immunosuppressive treatment3. The purpose of the study was to determine the impact of COVID-19 in the practice of rheumatologists. Methods: Cross-sectional study done using online surveys. We included demographics, COVID-19 infection and factors related to the care of patients with COVID-19. Participants completed the PHQ-9 questionnaire, subjective happiness scale and Maslach Burnout inventory. Data were analyzed using SPSS v22. Results: 297 rheumatologists were included, 62% women, 65% married, mainly of mixed race (52.9%). The countries with higher responses were Argentina 28.3%, Brazil 26.3%, Mexico 12.8%, Colombia 9.1% and Ecuador 7.7%. Of the entire group, 10.1% had already contracted COVID-19. Of the 30 infected, 53.3% had headache, 63.3% fatigue, 43.3% anosmia, 43.4% myalgia, 40% odynophagia, 33.3% ageusia, 30%cough, 30% chills, 30%arthralgia, 26.6% diarrhea, 23.3% fever, 16.6% abdominal pain, 13.3% dyspnea, 13.3% nausea/vomiting, and 6.7% skin lesions. Complications occurred in 20% of them. The mean duration of quarantine in the 15 Latin American countries was 40 ± 9 weeks. 48.5% had cared for patients with a presumed diagnosis of COVID-19 and only 32% had received personal protective equipment (Figure 1). The majority (77.4%) responded that doctors and health personnel in their country had received mistreatment by society and/or governments (figure 2). 83.8% have practiced telemedicine during the pandemic. Those who were in the front lines had similar scores as those who were not in the first line in terms of happiness scale (p > 0.05), emotional exhaustion score (p > 0.05), personal accomplishment (p > 0.05), depersonalization (p > 0.05) and practice satisfaction (p > 0.05). However, they did have higher PHQ-9 scores (p = 0.013). Those who were infected with COVID-19 had higher means in emotional exhaustion (p = 0.028) and depersonalization (p = 0.008) than those who were not infected. Conclusion: The pandemic opened the doors to the use of telemedicine and has shown that this could be an alternative for the follow-up of stable patients, in remission or those who have difficulties to move around, and in those who do not need a procedure to be performed.