Knowledge, attitudes, practices, and compliance of rheumatic disease patients toward COVID-19 during the late pandemic

Abstract

Abstract Background Rheumatic disease (RD) patients are liable for severe coronavirus disease 2019 (COVID-19). It is noticeable that RD patients’ practices have changed during the late COVID-19 pandemic. This study aimed to assess the knowledge, attitudes, practices, and compliance of RD patients during the late pandemic. Results This study included 188 patients with various RDs. The majority were female (61.7%) and were rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients (40.4% and 30.9%, respectively). We found knowledge deficiencies regarding some symptoms, contact isolation, and transmission. Negative attitudes toward COVID-19 final control were detected in a large proportion (50%). Furthermore, the majority did not think they were at risk of COVID-19 due to either RD (61.7%) or their drugs (66%). Their practices were also negative; the majority stopped wearing masks (56.4%) and went to crowded places recently (83%). Moreover, most did not stop or reduce their drugs for fear of COVID-19 but for availability issues (5.3% and 9.6% vs. 37.2%). Male gender and higher education and socioeconomic levels were significantly associated with better knowledge. In addition, RDs such as reactive arthritis, steroid use, lower steroid doses, COVID-19 vaccination, high education and socioeconomic levels, and Internet use as main knowledge sources had a significant association with better attitudes. Conventional disease-modifying anti-rheumatic drugs (DMARDs) use, biologics non-use, high education, severe functional impact, and compliance before the pandemic were significantly associated with higher practice scores. Knowledge was positively correlated with attitudes and practice (P = 0.0001 and 0.003, respectively). Moreover, attitudes were negatively correlated with age (P = 0.016). In multiple linear regression analysis, education, socioeconomic status, and practice were significant positive predictors of knowledge (P = 0.002, 0.001, and 0.046, respectively). Good knowledge, COVID-19 vaccination, younger age, and lower steroid doses were significant predictors of better attitudes (P = 0.02, 0.001, 0.02, and 0.002, respectively). Furthermore, non-use of biologics and functional disability were significant predictors of good practice (P = 0.002 and 0.015, respectively). Conclusion Improving knowledge and educating RD patients about the importance of protective measures is essentially needed to decrease the pandemic fatigue consequences and prevent serious COVID-19 complications in those patients.