• Nelly Ziadé, Ihsane Hmamouchi, Lina El Kibbi, Nizar Abdulateef, Hussein Halabi, Fatemah Abutiban, Wafa Hamdi, Manal El Rakawi, Mervat Eissa, and Basel Masri.
• Hotel-Dieu de France Hospital, Saint-Joseph University, 6th floor, Tour des Consultations Externes, Alfred Naccache blvd. Achrafieh, Beirut, Lebanon. nellziade@yahoo.fr.
• Clin. Rheumatol. 2020 Nov 1; 39 (11): 3205-3213.

ObjectiveTo evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on rheumatology practice.MethodA cross-sectional web survey was designed by the members of the Arab League of Associations for Rheumatology (ArLAR), validated by its scientific committee and disseminated through e-mail and social media. It included close-ended questions about the impact of the pandemic on the rheumatology activities, including outpatient visits and hospitalizations (in percentage, 100% corresponds to complete suspension) and open-ended questions about unmet needs. Univariate and multivariable logistic regression analyses were used to evaluate the predictors of impact. Suggestions were developed to improve the practice.ResultsA total of 858 rheumatologists were included in the analysis (27.3% of registered in ArLAR), 37% were 35-44 years old, 60% were females, and 48% worked in the private sector. The impact of COVID-19 was a decrease of 69% in hospitalizations, 65% in outpatient clinic, 56% in infusion centers, and 43% in income. It was associated with the region (highest in the Gulf), use of telemedicine, impact on income and practice sector (lowest in private). There was a hydroxychloroquine shortage in 47%. Telemedicine was mostly based on traditional telephone contacts and e-mails and reimbursed in 12%. Fifteen rheumatologists (1.8%) were infected and 156 cases of COVID-19 were reported among patients. The top-cited unmet needs in rheumatology practice were access to drugs and a telemedicine platform.ConclusionsThe negative impact of the COVID-19 pandemic on rheumatology practice may compromise rheumatic diseases control. Better access to drugs and providing telemedicine platforms are recommended to improve the practice. Key Points • The COVID-19 pandemic had a significant negative impact on the rheumatology practice, including access to outpatient clinic, hospitalization, and to anchor drugs. • The compromised access to rheumatology care may jeopardize the control of chronic rheumatic diseases and the long-term prognosis. • Better access to drugs and providing telemedicine platforms are strongly recommended.

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