Psychosocial and clinical impact of COVID-19 pandemic and its relationship to the quality of life in patients with rheumatoid arthritis: a cross-sectional study, Egypt

Background Data have been pouring on the impact of the COVID-19 pandemic on patients with chronic diseases. This study aimed to address the relationship between the perceived fears of COVID-19 virus (FCV), psychological status, and quality of life (QoL) among patients with rheumatoid arthritis (RA) during the pandemic. This study included 100 patients with RA and an equal number of control subjects, who were recruited from Zagazig University rheumatology outpatient clinics, Egypt. All subjects were interviewed using the fear of COVID-19 scale (FCV-19S), Symptom Checklist-90 scale (SCL-90), and World Health Organization Quality of Life Scale (WHOQOL-BREF). Patients were additionally assessed using the Disease Activity Score 28 (DAS28) and Modified Health Assessment Questionnaire (MHAQ). Results There were significant differences between both groups in all QoL domains and most psychological dimensions. Most patients with RA experienced moderate-to-high disease activity and mild-to-moderate functional impairment (85% and 80%, respectively). FCV was correlated with the number of family members (P-value 0.020), and obsessive-compulsive (P-value 0.006), interpersonal sensitivity (P-value 0.035), hostility (P-value 0.017), phobia (P-value 0.010), and psychoticism (P-value 0.034) symptoms. Moderate-to-high disease activity was associated with reduced psychological QoL. Patients with moderate-to-severe functional impairment had worse QoL in all domains (except social). Prolonged illness duration was associated with worse social QoL. Conclusions QoL was adversely affected in patients with RA during the pandemic. There was a robust relationship between FCV and the emergence of psychological symptoms. RA-related clinical factors like illness duration, disease activity, and functional disability were associated with reduced QoL in those patients.