Thousands of arthritis cases ‘were missed during Covid’


Thousands of cases of arthritis were missed during Covid, according to another study laying bare the knock-on effects of the pandemic. 

Researchers said ‘there is likely to be a substantial burden of undiagnosed patients’ as they did not see a rebound in diagnoses after restrictions were lifted.

It means many patients who might have the disease have not been seen by their GP or been reviewed by a hospital specialist, with cases not having jumped up above pre-2020 levels until April this year, they said.

Researchers said ‘there is likely to be a substantial burden of undiagnosed patients’ as they did not see a rebound in diagnoses after restrictions were lifted (stock)

The study, by researchers from King’s College London and published in The Lancet Rheumatology journal, evaluated care for 31,000 people with new diagnoses of arthritis between April 2019 and March 2022 from a study population of over 17million people in England.

It found that the number of newly recorded arthritis diagnoses fell by 20 per cent in the year after the first Covid lockdown compared to the year before the pandemic.

Researchers used OpenSAFELY, a highly secure health data platform, to determine how the diagnosis and management of arthritis was affected by the pandemic.

More than 400,000 adults in the UK have rheumatoid arthritis, according to the National Rheumatoid Arthritis Society.

Rheumatoid arthritis is an autoimmune disease where the immune system attacks the lining of the joints, causing inflammation, stiffness, pain and extreme fatigue.

If left untreated, the joint can lose its shape and alignment and lead to permanent disability meaning early diagnosis and treatment improves outcomes for patients.

Once diagnosed, patients can start highly effective treatments to control symptoms and prevent irreversible damage.

The study found that there did not appear to be more delays in starting treatment for patients who were diagnosed during the pandemic.

It also said the time to assessment by a hospital specialist was shorter than before the pandemic, which could have been due to fewer hospital referrals overall and increased utilisation of virtual appointments during the pandemic.

Each year the quality of care for people with rheumatoid arthritis is benchmarked through a process of national audit. 

These audits were paused during the pandemic, however, making comparisons of care challenging.

‘Lead author Dr Mark Russell, from King’s College London, said: ‘This study highlights that there are likely to be people with joint pain and swelling who remain undiagnosed as a consequence of the pandemic. 

‘It is important to speak to a doctor if you have these symptoms, as early diagnosis and treatment of conditions such as rheumatoid arthritis greatly improves outcomes for patients and increases the likelihood of disease remission.

‘An important message of this study is that it is possible to assess the quality of care for patients with long-term health conditions using routinely collected health data. 

‘This approach could be applied to many other chronic health conditions and be used to provide feedback to NHS organisations and clinicians, with the aim of optimising care for patients.’

Dr Benjamin Ellis, consultant rheumatologist and senior clinical advisor to charity Versus Arthritis said: ‘Inflammatory types of arthritis, such as rheumatoid arthritis and psoriatic arthritis, are conditions where the immune system attacks the joints and surrounding tissues. 

‘They cause swelling, agonising pain, stiffness and joint damage, and can take away a person’s ability to live independently. People who develop inflammatory arthritis need urgent, intensive treatment from rheumatology specialists, as delays in diagnosis and treatment can lead to long-term pain and disability. 

‘This study suggests that during the Covid-19 pandemic around 2,700 people did not get the diagnosis they needed to access treatment and support. 

‘Worryingly, the figures since the pandemic suggest the NHS has not yet caught up, and people are being left in severe and unnecessary pain. 

‘The NHS must identify who these people are and focus on accelerating their treatment to prevent further unnecessary risk of harm.’

WHAT IS RHEUMATOID ARTHRITIS? THE AGONISING LONG-TERM ILLNESS THAT IS INCURABLE

Rheumatoid arthritis (RA) affects around 400,000 people in the UK

Rheumatoid arthritis (RA) affects around 400,000 people in the UK

Rheumatoid arthritis (RA) affects around 400,000 people in the UK and nearly 1.3 million adults in the US.

Women are up to three times more likely to develop the condition than men. Those with family history of rheumatoid arthritis are also more vulnerable.

It is a long-term illness in which the immune system causes the body to attack itself, causing painful, swollen and stiff joints.  

RA, the second most common form of arthritis that often begins between the ages of 40 and 50, tends to strike the hands, wrists and knees.

Scientists are currently unsure as to the exact cause of RA, but smoking, eating lots of red meat and coffee drinkers are at higher risk. 

A cure has yet to be found, but treatments are available and proven to help slow down the progressive condition. 

RA is a complex autoimmune condition that is diagnosed and treated by a Consultant Rheumatologist in secondary care and the patient is followed up on a regular basis by a consultant-led multi-disciplinary team in hospital. 

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