Volume 76, Issue 1 p. 22-31
Review Article

Global Perspective on the Impact of the COVID-19 Pandemic on Rheumatology and Health Equity

Evelyn Hsieh

Corresponding Author

Evelyn Hsieh

Yale School of Medicine, New Haven, Connecticut, and VA Connecticut Healthcare System, West Haven, Connecticut

Address correspondence via email to Evelyn Hsieh, MD, PhD, at [email protected], and Jinoos Yazdany, MD, MPH, at [email protected].

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Dzifa Dey

Dzifa Dey

Korle-bu Teaching Hospital and the University of Ghana Medical School, Accra, Ghana

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Rebecca Grainger

Rebecca Grainger

University of Otago, Wellington, New Zealand

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Mengtao Li

Mengtao Li

Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China

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Pedro M. Machado

Pedro M. Machado

University College London, NIHR University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, Northwick Park Hospital, and London North West University Healthcare NHS Trust, London, UK

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Manuel F. Ugarte-Gil

Manuel F. Ugarte-Gil

Universidad Científica del Sur and Hospital Nacional Guillermo Almenara Irigoyen - EsSalud, Lima, Perú

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Jinoos Yazdany

Corresponding Author

Jinoos Yazdany

San Francisco General Hospital and University of California, San Francisco

Address correspondence via email to Evelyn Hsieh, MD, PhD, at [email protected], and Jinoos Yazdany, MD, MPH, at [email protected].

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First published: 05 June 2023
Citations: 2

Author disclosures are available at https://onlinelibrary.wiley.com/doi/10.1002/acr.25169.

Abstract

Although the public health emergency associated with the COVID-19 pandemic has ended, challenges remain, especially for individuals with rheumatic diseases. We aimed to assess the historical and ongoing effects of COVID-19 on individuals with rheumatic diseases and rheumatology practices globally, with specific attention to vulnerable communities and lessons learned. We reviewed literature from several countries and regions, including Africa, Australia and New Zealand, China, Europe, Latin America, and the US. In this review, we summarize literature that not only examines the impact of the pandemic on individuals with rheumatic diseases, but also research that reports the lasting changes to rheumatology patient care and practice, and health service use. Across countries, challenges faced by individuals with rheumatic diseases during the pandemic included disruptions in health care and medication supply shortages. These challenges were associated with worse disease and mental health outcomes in some studies, particularly among those who had social vulnerabilities defined by socioeconomic, race, or rurality. Moreover, rheumatology practice was impacted in all regions, with the uptake of telemedicine and changes in health care utilization. While many regions developed rapid guidelines to disseminate scientific information, misinformation and disinformation remained widespread. Finally, vaccine uptake among individuals with rheumatic diseases has been uneven across the world. As the acute phase of the pandemic wanes, ongoing efforts are needed to improve health care access, stabilize rheumatology drug supplies, improve public health communication, and implement evidence-based vaccination practices to reduce COVID-19 morbidity and mortality among individuals with rheumatic diseases.