Atopic Dermatitis Day: the Covid-19 pandemic aggravated the situation for patients

The Argentine Atopic Dermatitis Association (ADAR) and the Civil Association for the Psoriasis Patient (AEPSO), two organizations that work to accompany and advise people with this disease and their families, came together to carry out a poll on the situation that patients went through (and are going through) from the COVID-19 pandemic. They inquired about quality of life, access to health, work situation, eating habits, physical activity and stress levels and presented the results within the framework of the World Atopic Dermatitis Day, which is commemorated this Tuesday, September 14.

From the survey, called ‘Evolution of patients with atopic dermatitis during the COVID-19 pandemic’, 535 patients participated online across the country between June 12 and July 8 of this year.

“We start from the premise that this adverse context impacted -although in different ways- on all human beings, but that the obstacles could have been even more challenging for the community of people who live with a chronic disease like this and in the context of our country. We set out to understand this reality to later share the findings with health policy decision-makers “, Held Silvia Fernandez Barrio, President of AEPSO.

Anxiety (52.9%), anguish (43.2%), tiredness (40.4%) and burnout (39.6%) were the main feelings experienced by patients regarding their illness during quarantine. “We have all gone through emotions of this kind throughout these 18 months, but the coexistence of a chronic illness exacerbates the situation, accentuating or enlarging other complications that we face “, indicated Mariana Palacios, president of ADAR.

This is an inflammatory and chronic skin disease, characterized by frequent breakouts, intense itching, irritation, pain, redness, scabs, and infections. During the pandemic, the 55% of patients rated their atopic dermatitis as moderate or high and, compared to how they felt before March 2020, for half, their illness got worse. In addition, for 62.8% the itching during quarantine was (and is) moderate or high, 41.3% more than before.

The itch it is not a minor aspect. People whose skin itches chronically and intensely are three times as likely to develop depression and twice as likely to experience anxiety. Other research has already shown that mental health disorders in people with skin conditions are often directly linked to the level of itchiness.

Chronic itching can lead to depression and anxiety.

Before quarantine, 62.1% were in treatment for your atopic dermatitis (especially with emollient or moisturizing creams and corticosteroid creams), but 18.1% had to discontinue it, generally for economic reasons and 1 in 10 He decided -on his own- to suspend the medication for fear of COVID-19.

“We also learned of cases that were receiving systemic treatments, both older drugs and modern monoclonal antibodies, and suffered ‘bureaucratic’ interruptions due to the closure of offices of social and prepaid works. That was restored, but it would give the impression that there are obstacles that are here to stay and we are concerned about the future of access to treatments for this type of chronic diseases “Fernández Barrio remarked.

The pandemic, as in the rest of the people, impacted on the labor plane: 13% of patients lost their jobs against 7.1% who got one. “Having a chronic illness and changing jobs can be dramatic. First, because you have to deal with unfounded stigmas that prevent you from being hired again, but then because, perhaps, the new job offers medical coverage that does not cover certain benefits you need or the medical team that was treating you. It is starting over, redoing your medical history, re-managing the treatment that has been working for you, with all the time and effort that this takes, giving the disease several meters of advantage. In fact, 7.1% lost their health coverage in the pandemic, recognized the specialist.

7.1% of people with atopic dermatitis lost their health coverage in the pandemic.

Among those who needed to be hospitalized for their dermatitis in this year and a half, which fortunately were a minority (5.6%, although the percentage rose to 15.7% in children between 1 and 5 years old), 1 in 5 found it difficult to get a bed. “Let’s put ourselves for a moment in the place of a family with a baby with a generalized outbreak, this means a body with eczema, infections, pain, itching and without the possibility of attending a medical center to be treated. They are traumatic experiences that you do not forget any more “, stressed Mariana Palacios.

Of all respondents, 66.3% had scheduled controls as of March 2020, but only 3 out of 10 were able to carry them out and 38.5% did it by telemedicine (via Whatsapp 72.4% of the time). “The technology showed that it can be part of the solution of a complex problem that we have in Argentina, which is the lack of specialists (and equipment) in many cities of the country, which force the patient to travel long distances to receive medical attention”Added Palacios.

As explained by the Dr. Paula Luna, specialist in dermatology and pediatric dermatology of the German Hospital, “lface-to-face consultation is irreplaceable, but teleconsultation would be a valid complement because these skin diseases can be followed up with photos or a video call “.

As atopic dermatitis shares the underlying inflammatory process with other diseases, known as ‘type 2 inflammation’, Dr. Luna said it was not surprising that 7 out of 10 participants will have an environmental allergy (47.1%), food allergy (20.2%), asthma (15.7%) and, to a lesser extent, polyposis, rhinoconjunctivitis and eosinophilic esophagitis.

More obesity, sedentary lifestyle and stress

On average, survey participants they gained 2 kg. in the pandemic and 10% increased more than 10 kg. The realization of physical activity (60.6% do not exercise, but of that total, 1 in 4 did so before the pandemic, gave up and have not returned to it yet).

“We must pay attention to these data, because being a systemic and inflammatory disease, its link with obesity and cardiovascular complications, comorbidities that have already been widely demonstrated in other diseases such as psoriasis “, Dr. Luna pointed out.

Six out of ten patients consider that your current stress level is high or very high, 34% more than in the prepandemic world. On the other hand, 6 out of 10 affirm that the quality of your sleep The current situation is fair or bad and for 37.8% it worsened.

One in five patients who required hospitalization during the pandemic found it difficult to obtain a bed.

“During the beginning of the quarantine many mental health treatments were interrupted because psychologists have not been declared essential personnel and therefore we had to stop the treatments. For different reasons many patients have not been able to adapt to telemedicine, which has further aggravated their situation “, Held Laura Resnichenco, Graduated in Psychology, member of ADAR.

Another important result that the survey yielded is that almost 90% agree to get vaccinated (When the survey was run, 34.2% had done so). The existence of the remaining 10%, who would not be vaccinated, represents a alarm signal: “It would be necessary to inquire about the reasons, but vaccination saves millions of lives per year. If a patient has doubts about the advisability of being vaccinated due to the type of treatment they are receiving, they can consult with your doctor and will most likely tell you to do so. It is always important to maintain a fluid and trustworthy dialogue with the health professional who is treating your atopic dermatitis “concluded Dr. Luna.

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