Impact of covid-19 pandemic in ecuadorian patients with rheumatic diseases

Objectives: Ecuador has been affected by the COVID-19 pandemic since March 2020. The impact of the infection in rheumatic patients is still being examined. The purpose of the study was to describe the clinical demographics and impact of COVID19 in of Ecuadorian patients with rheumatic conditions. Methods: Rheumatologists practicing in Ecuador reported the data from June 2020 to February 2021, demographic data, clinical status, rheumatic treatment and COVID-19 directed therapy was retrieved. Data were analyzed in SPSS v22. Results: A total of 114 patients with COVID-19 and primary diagnosis of rheumatic disorders were registered, 78% female and 22% male with a mean age of 50.5 ± 16.6 [23-83].Most patients were considered as Mestizo/mixed race 88% [100]. Primary diagnosis included rheumatoid arthritis 42%, osteoarthritis 19%, systemic lupus erythematous 15%, fibromyalgia 8%, ankylosing spondylitis 4%, other seronegative disorders 3%, gout 3%, Sjogren syndrome 2%, polymyalgia rheumatica 2%, dermatomyositis and psoriatic arthritis 1%. Medications for rheumatic disorders included methotrexate 33%, glucocorticoids 40%, hydroxychloroquine 20%, biologics 8%, anti-TNF 9%, tofacitinib 2%, among others. 83%of the sample were in remission or controlled disease before getting infected by COVID-19. COVID-19 symptoms included fever 74%, chills 28%, cough 55%, sore throat 46%,myalgia 47%, anosmia 41%, headache 39%, arthralgia 38%, fatigue 35%, dyspnea 6%, nausea and vomiting 8%, diarrhea 35%, abdominal pain 10%, ageusia 31%, skin lesions 5%. 92%spent the clinical course at home and 9% hospitalized with a mean of days of stay of 18.7 ± 5.4 [4-60]. 45% of the patients required treatment adjustments for the rheumatic conditions. 82% have a resolved clinical course of the infection. 40% of the patients with controlled/remission RA experienced a flare after COVID-19 infection and SLE patients flared in 19%. 3% of the patients died from COVID-19 infection. Conclusion: This is the first study of rheumatic patients with history of COVID-19 infection in Ecuador. The majority (86%) of the patients were in remission before the infection. COVID-19 triggered flares in 40% of RA patients and on 19%of SLE patients with well controlled disease before viral infection. It is still unknown the long-term effects of COVID-19 in rheumatic patients;however, it is evident that it has a negative impact on disease activity.