Impact of COVID-19 pandemic on rheumatology practice in Latin America

Daniel G. Fernández-Ávila, Julián Barahona-Correa, Diana Romero-Alvernia, Sergio Kowalski, Ana Sapag, Antonio Cachafeiro-Vilar, Belia Meléndez, Carlos Santiago-Pastelín, Daniel Palleiro, Dina Arrieta, Gil Reyes, Guillermo J. Pons-Estel, Jossiell Then-Báez, Manuel F. Ugarte-Gil, Mario H. Cardiel, Nelly Colman, Nilmo Chávez, Paula I. Burgos, Rubén Montúfar, Sayonara SandinoYurilis J. Fuentes-Silva, Enrique R. Soriano

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. To describe the effect of the coronavirus disease 2019 (COVID-19) pandemic on Latin American rheumatologists from a professional, economic, and occupational point of view. Methods. We conducted an observational cross-sectional study using an online survey sent to rheumatologists of each non–English-speaking country member of the Pan American League of Rheumatology Associations (PANLAR). A specific questionnaire was developed. Results. Our survey included 1097 rheumatologists from 19 Latin American countries. Median (IQR) age of respondents was 48 (40–59) years and 618 (56.3%) were female. Duration of practice since graduation as a rheumatologist was 17 years, and 585 (53.3%) were aged < 50 years. Most rheumatologists worked in private practice (81.8%) and almost half worked in institutional outpatient centers (55%) and inpatient care (49.9%). The median number of weekly hours (IQR) of face-to-face practice before the pandemic was 27 (15–40) hours, but was reduced to 10 (5–20) hours during the pandemic. Telehealth was used by 866 (78.9%) respondents during the pandemic. Most common methods of communication were video calls (555; 50.6%), telephone calls (499; 45.5%), and WhatsApp voice calls (423; 38.6%). A reduction in monthly wages was reported by 946 (86.2%) respondents. Consultation fees also were reduced and 88 (8%) rheumatologists stated they had lost their jobs. A reduction in patient adherence to medication was reported by nearly 50% of respondents. Eighty-one (7.4%) rheumatologists received a COVID-19 diagnosis and 7 (8.6%) of them were hospitalized. Conclusion. The COVID-19 pandemic has reshaped rheumatology practice in Latin America and has had a profound effect on rheumatologists’ behaviors and clinical practice.

Original languageEnglish
Pages (from-to)1616-1622
Number of pages7
JournalJournal of Rheumatology
Volume48
Issue number10
DOIs
StatePublished - 1 Oct 2021

Bibliographical note

Funding Information:
This study was supported by an unrestricted grant from the Pan American League of Rheumatology Associations (PANLAR). 1D.G. Fernández-Ávila, MD, Unidad de Reumatología, Pontificia Universidad Javeriana - Hospital Universitario San Ignacio, Bogotá, Colombia; 2J. Barahona-Correa, MD, D. Romero-Alvernia, MD, Departamento de Medicina Interna, Pontificia Universidad Javeriana -Hospital Universitario San Ignacio, Colombia; 3S. Kowalski, MD, Universidade Federal do Paraná, Paraná, Brazil; 4A. Sapag, MD, Hospital Universitario Japonés, Santa Cruz, Bolivia; 5A. Cachafeiro-Vilar, MD, Pacífica Salud - Hospital Punta Pacífica, Panama City, Panama; 6B. Meléndez, MD, Hospital de la Policía Nacional N1 Quito, Quito, Ecuador; 7C. Santiago-Pastelín, MD, Instituto Hondureño de la Seguridad Social, Tegucigalpa, Honduras; 8D. Palleiro, MD, Instituto Nacional de Reumatología del Uruguay, Universidad de la República, Montevideo, Uruguay; 9D. Arrieta, MD, Hospital México, San José de Costa Rica, Costa Rica; 10G. Reyes, MD, Universidad de Ciencias Médicas de la Habana, Havana, Cuba; 11G.J. Pons-Estel, MD, Centro Regional de Enfermedades Autoinmunes y Reumáticas CREAR, Rosario, Argentina; 12J. Then-Báez, MD, Hospital Metropolitano de Santiago (HOMS), Santiago, Dominican Republic; 13M.F. Ugarte-Gil, MD, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud - Universidad Científica del Sur, Lima, Peru; 14M.H. Cardiel, MD, Centro de Investigación Clínica de Morelia, Morelia, Mexico; 15N. Colman, MD, Hospital de Clínicas - Universidad Nacional de Asunción, Asunción, Paraguay; 16N. Chávez, MD, Instituto Guatemalteco de Seguridad Social - Universidad San Carlos de Guatemala, Ciudad de Guatemala, Guatemala; 17P.I. Burgos, MD, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile; 18R. Montúfar, MD, Consultorio de Especialidades del Instituto Salvadoreño del Seguro Social, San Salvador, El Salvador; 19S. Sandino, MD, Instituto Médico Ganna, Managua, Nicaragua; 20Y.J. Fuentes-Silva, MD, Centro Clínico Universitario de Oriente -Universidad de Oriente, Ciudad Bolívar, Venezuela; 21E.R. Soriano, MD, Sección Reumatología, Servicio de Clinica Médica Hospital Italiano de Buenos Aires - Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. D.G. Fernández-Ávila, Cra 7 No. 40-62. Piso 7, Unidad de Reumatología, Hospital Universitario San Ignacio, Bogotá, Colombia. Email: daniel.fernandez@javeriana.edu.co. Accepted for publication May 28, 2021.

Publisher Copyright:
© 2021 The Journal of Rheumatology.

Keywords

  • COVID-19
  • Guidelines
  • Practice
  • Rheumatology
  • Telehealth

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