Work participation and the COVID-19 pandemic: an observational study in people with inflammatory rheumatic diseases and population controls

Objective During the coronavirus disease 2019 (COVID-19) crisis, people with inflammatory rheumatic diseases (iRDs) might have been more vulnerable for adverse work outcomes (AWOs) and restrictions in work ability and work performance. Our objectives were to compare AWOs during the pandemic and current work ability between iRD patients and controls, understand which patients are most vulnerable for these outcomes and (3) explore the role of work characteristics on work performance while working remotely.Methods Patients and population controls in a Dutch COVID-19 cohort study provided information in March 2022 on work participation in March 2020 (pre-pandemic, retrospective) and March 2022 (current). AWOs comprised withdrawal from paid work, working hours reduction or long-term sick leave. Multivariable logistic/linear regression analyses compared outcomes (AWOs/work ability) between groups (patients/controls) and within patients.Results Of the pre-pandemic working participants, 227/977 (23%) patients and 79/430 (18%) controls experienced AWOs following pandemic onset. A minority of AWOs (15%) were attributed to COVID-19. Patients were more likely to experience any-cause AWOs (odds ratio range 1.63-3.34) but not COVID-related AWOs, with female patients and patients with comorbidities or physically demanding jobs being most vulnerable. Current work ability was lower in female patients compared with controls [beta = -0.66 (95% CI -0.92 to -0.40)]. In both groups, when working remotely, care for children and absence of colleagues had varying effects on work performance (positive 19% and 24%, negative 34% and 57%, respectively), while employer support and reduced commuting had mainly positive effects (83% and 86%, respectively).Conclusion During the pandemic, people with iRDs remained at increased risk of AWOs. COVID-related AWOs, however, were infrequent.What does this mean for patients?People with inflammatory rheumatic diseases (iRDs), such as RA or SpA, often experience restrictions in their work. In times of crises, such as the COVID-19 pandemic, people with iRDs might be more vulnerable in their work situation. We were interested to know whether people with iRDs were more likely to stop working, reduce their working hours or were on long-term sick leave during the pandemic compared with the general population. In the Amsterdam COVID-19-cohort, we found that 23% of people with iRDs and 18% of the general population had to stop work, reduce work hours or were on long-term sick leave, 2 years after the onset of the pandemic. Only a small portion of these adverse work outcomes were directly related to COVID-19 (illness, containment measures, etc.). Female patients, those suffering from other health issues (along with iRDs) or patients with physically demanding jobs experienced the greatest impact. Additionally, we explored which working conditions influenced work performance if working from home. Childcare responsibilities and the absence of colleagues had both positive and negative effects. Support from employers and reduced commuting had overall positive impacts for both people with iRDs and the general population. This study contributes to a better understanding on how to support people with iRDs in healthy and sustainable paid work, now and in the future.