Impact of Covid-19 pandemic on injection-based practice: report from an italian multicenter and multidisciplinary survey

Background. There are no papers exploring the impact of COVID-19 pandemic on the injection-based practice in patients affected by different rheumatic diseases, including osteoarthritis. The aim was to investigate the impact of COVID-19 pandemic on injection-based practice trough the Italian country. Study design. A survey-based retrospective cross-sectional study Methods. An Italian-language questionnaire was developed by a group of senior researchers and distributed by e-mail to some Rheumatology, Orthopedic and Rehabilitation Units from different geographic areas of Italy. The survey included information about the number of injections performed during COVID-19 pandemic (stratified by injected agents and injected joint), in comparison to the pre-pandemic period, and the possible reasons behind an eventual reduction. Responses were collected and descriptive analysis calculated. Results. Eleven centers of the National Health Service completed the survey. The activities of the injections services significantly decreased across the country with a percentage of reduction of 60% compared to the pre-pandemic period. A significant reduction of both intra-articular and peri-articular injections was registered. Among intra-articular. treatments, the most affected ones were the hyaluronic acid injections, when compared to corticosteroids. A significant decrease of the total amount of peri-articular injections was observed. The strict government restrictions and the fear of patients to become infected represented the most limiting factors. Conclusions. The reported decrease of the injection-based practice in our country during the COVID-19 pandemic highlights the detrimental effects of the COVID-19 pandemic on the management of chronic musculoskeletal diseases with possible negative consequences in terms of disability and quality of life.

Premessa. Non ci sono documenti che indagano l’impatto della pandemia di COVID-19 sulla pratica infiltrativa in pazienti affetti da diverse malattie reumatiche, inclusa l’osteoartrite. Lo scopo è stato quello di indagare l’impatto della pandemia di COVID-19 sulla pratica infiltrativa attraverso il paese italiano. Disegno dello studio. Studio trasversale retrospettivo basato su una survey. Risultati. Undici centri del Servizio Sanitario Nazionale hanno completato l’indagine. Le attività dei servizi infiltrativi sono notevolmente diminuite su tutto il territorio nazionale con una percentuale di riduzione del 60% rispetto al periodo pre-pandemico. È stata registrata una significativa riduzione delle iniezioni sia intra-articolari che peri-articolari. Tra trattamenti intra-articolari, quelli più colpiti sono stati le iniezioni di acido ialuronico, rispetto ai corticosteroidi. È stata osservata una significativa diminuzione della quantità totale di iniezioni peri-articolari. Le rigide restrizioni governative e la paura dei pazienti di contrarre l’infezione rappresentavano ifattori più limitanti. Conclusioni. La diminuzione segnalata della pratica infiltrativa nel nostro paese durante la pandemia COVID19 evidenzia gli effetti dannosi della pandemia COVID19 sulla gestione delle malattie muscolo-scheletriche croniche con possibili conseguenze negative in termini di disabilità e qualità della vita.