Factors Related to Experiencing Pain in Patients Affected by Chronic Inflammatory Rheumatic Disease During the COVID-19 Pandemic

Tfarah El Joumani1, *, Hanan Rkain1, Fatima Zahrae Taik1, Kenza Hassouni2, Redouane Abouqal3, Sara Bahloul1, Nada Alami1, Latifa Tahiri1, Najia Hajjaj-Hassouni4, Fadoua Allali1
1 Department of Rheumatology B, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
2 Ecole Internationale de Santé Publique, Université Mohammed VI des Sciences de la Santé, Casablanca, Morocco.
3 Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
4 International University of Rabat, Rabat, Morocco

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© 2022 El Joumani et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Rheumatology B, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco; Tel: 00212661090833; E-mail:



To evaluate the effects of the COVID-19 pandemic on the pain experienced by patients with CIRD and to analyze the associated factors.


A cross-sectional study was conducted amongst patients with rheumatic diseases using a questionnaire providing information on patients and disease characteristics.

Patients were asked to assess the level of pain they had experienced before and during the pandemic, using a single Visual Analogue Scale (VAS) ranging from 0 (no pain) to 10 (greatest pain).

Statistical Analysis System IBM SPSS Statistics V20.0.0 was used to analyze the study data.

We performed univariate multivariate analysis to search for any related factors to pain perception during the COVID-19 pandemic. Qualitative values were analyzed by the chi2 test. Quantitative values were analyzed by the Student test when the measures were normally distributed or by nonparametric tests (Mann–Whitney U) when the measures were not normally distributed (the Kolmogorov–Smirnov test was used to test normality).


Amongst the 350 patients who answered the questionnaire online, rheumatoid arthritis represented 62.3%, spondyloarthropathy 34.3%, and undifferentiated CIRD 3.4%. CIRD-related pain was reported by 79.1% of the patients

The level of pain, using the VAS of Pain, increased significantly during the COVID-19 pandemic (4,6 ± 2,8 and 5,4 ± 3 before and during the pandemic; p<0.001).

In the multivariate analysis, the factors causing the pain were: the negative impact of the coronavirus on accessing rheumatology care, the discontinuation of treatment, the disturbed sleep, and the negative psychological impact.


This survey showed that the COVID-19 pandemic had increased CIRD-related pain in patients. Factors influencing this pain should be considered to help patients cope with their chronic rheumatism in this global health crisis.

Keywords: COVID-19 pandemic, Pain, Chronic inflammatory rheumatic diseases, Treatment adherence, Follow-up, Impact.