GCA diagnosis rates increased during the COVID-19 pandemic
medwireNews: There was a “large rise” in the number of people being diagnosed with giant cell arteritis (GCA) during the peak of the COVID-19 pandemic, along with an increase in the proportion of patients with associated visual impairment, UK researchers report.
“While the reasons behind this are as yet unclear our findings support the viral aetiopathogenesis hypothesis for GCA and highlight the importance of maintaining urgent access to rheumatology services during this time of uncertainty and re-organisation of healthcare services,” say Sarah Tansley and colleagues from the Royal United Hospitals Bath NHS Foundation Trust.
In their review of electronic health records, the study authors found that among 118 patients attending their center for fast-track assessment of suspected GCA in January–September 2020, 50 (42%) received a GCA diagnosis. Almost half (n=24) of these diagnoses were made between April and June 2020, and 25% of people diagnosed during this period had GCA-associated visual impairment.
By comparison, just 28 new diagnoses of GCA were made over the whole of 2019, with 10% having visual involvement. Tansley et al also point out that the number of diagnoses made between April and June 2020 was almost fivefold higher than the number of diagnoses made during the same time period of 2019 (n=5).
The researchers note in Rheumatology Advances in Practice that COVID-19 restrictions “precluded temporal artery biopsy” during the peak of the pandemic, but “temporal artery ultrasound availability was unaffected.” Overall, the proportion of GCA diagnoses confirmed by imaging or biopsy was higher in April–June 2020 (60–72%) compared with the same period in 2019 (40%).
“While a greater proportion of our referrals were diagnosed with GCA than in 2019, the higher proportion of diagnoses supported by imaging suggests clinical diagnoses were not being made more readily owing to restrictions around access to diagnostic temporal artery biopsies,” write Tansley et al.
They report that none of the patients with GCA had symptoms of COVID-19 at the time of diagnosis or follow-up assessment, and of the “limited number” of patients tested so far, none had SARS-CoV-2 antibodies to suggest previous exposure.
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2020 Springer Healthcare Ltd, part of the Springer Nature Group
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