COVID-19 and rheumatic musculoskeletal disease patients: infection rates, attitudes and medication adherence in an Irish population

Rheumatology (Oxford). 2021 Feb 1;60(2):902-906. doi: 10.1093/rheumatology/keaa694.


Objectives: To establish, amongst Irish rheumatic musculoskeletal disease (RMD) patients, rates of COVID-19 symptoms and positive tests, DMARD adherence and attitudes to virtual clinics.

Methods: An online survey assessing COVID-19 status, RMD diagnoses, adherence and information sources was disseminated via the Arthritis Ireland website and social media channels.

Results: There were 1381 respondents with 74.8% on immunosuppressive medication. Symptoms of COVID-19 were reported by 3.7% of respondents of which 0.46% tested positive, consistent with the general Irish population. The frequency of COVID-19 symptoms was higher for respondents with spondyloarthropathy [odds ratio (OR) 2.06, 95% CI: 1.14, 3.70] and lower in those on immunosuppressive medication (OR 0.48, 95% CI: 0.27, 0.88), and those compliant with health authority (HSE) guidance (OR 0.47, 95% CI: 0.25, 0.89). Adherence to RMD medications was reported in 84.1%, with 57.1% using health authority guidelines for information on medication use. Importantly, adherence rates were higher amongst those who cited guidelines (89.3% vs 79.9%, P <0.001), and conversely lower in those with COVID-19 symptoms (64.0% vs 85.1%, P =0.009). Finally, the use of virtual clinics was supported by 70.4% of respondents.

Conclusion: The rate of COVID-19 positivity in RMD patients was similar to the general population. COVID-19 symptoms were lower amongst respondents on immunosuppressive medication and those adherent to medication guidelines. Respondents were supportive of HSE advice and virtual clinics.

Keywords: COVID-19; immunosuppression; infection; medication adherence; rheumatoid arthritis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / drug therapy
  • Attitude to Health*
  • Biological Products / therapeutic use
  • COVID-19 / epidemiology*
  • COVID-19 / physiopathology
  • Chloroquine / therapeutic use
  • Connective Tissue Diseases / drug therapy
  • Cross-Sectional Studies
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Ireland / epidemiology
  • Janus Kinase Inhibitors / therapeutic use
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Rheumatic Diseases / drug therapy*
  • SARS-CoV-2
  • Spondylarthropathies / drug therapy
  • Telemedicine
  • Vasculitis / drug therapy


  • Antirheumatic Agents
  • Biological Products
  • Glucocorticoids
  • Janus Kinase Inhibitors
  • Hydroxychloroquine
  • Chloroquine