COVID-19-related anxiety trajectories in children, young people and adults with rheumatic diseases

Stephanie J. W. Shoop-Worrall, Suzanne M. M. Verstappen, Wendy Costello, Saskya P. Angevare , Yosef Uziel, Carine Wouters, Nico Wulffraat, Richard Beesley

Research output: Contribution to journalArticlepeer-review


Objectives: Uncertainty regarding the risk of COVID-19, its complications and the safety of immunosuppressive therapies may drive anxiety amongst adults and parents of children and young people (CYP) with rheumatic diseases. This study explored trajectories of COVID-related anxiety in adults and parents of CYP with rheumatic diseases.

Methods: Adults and parents of CYP participating in the international COVID-19 European Patient Registry were included in the current study, if they had enrolled in the four weeks following 24 March 2020. COVID-related anxiety scores (0 to 10) were collected weekly for up to 28 weeks.
Group-based trajectory models explored COVID-related anxiety clusters in adult and parent populations, with optimal models chosen based on model fit, parsimony and clinical plausibility. Demographic, clinical and COVID-19 mitigation behaviours were compared between identified clusters using univariable statistics.

Results: Within 498 parents of CYP and 2,640 adults, four common trajectory groups of COVID-related anxiety were identified in each cohort: persistent extreme anxiety (32%, 17%), persistent high anxiety (43%, 41%), improving high anxiety (25%, 32%) and improving moderate anxiety (11%, 10%), respectively. Few characteristics distinguished the clusters in the parent cohort. Higher and more persistent anxiety clusters in the adult cohort were associated with higher levels of respiratory comorbidities, use of immunosuppressive therapies, older age and greater self-isolation.

Conclusions: COVID-19-related anxiety in the rheumatic disease community is high and persistent during the COVID-19 pandemic, with four common patterns identified. In the adult cohort, higher COVID-related anxiety was related to perceived risk factors for COVID-19 morbidity and mortality.
Original languageEnglish
JournalRheumatology Advances in Practice
Issue number1
Early online date11 Jan 2023
Publication statusE-pub ahead of print - 11 Jan 2023


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