Background The COVID-19 pandemic has introduced significant changes in the workplace, implementing teleworking as an effective solution to reduce contagion

Objectives We sought to explore the impact of working from home on people with rheumatic and musculoskeletal diseases (RMDs) in Europe during the COVID-19 pandemic.

Methods REUMAVID is an international cross-sectional study collecting data through an online survey in seven European countries led by the Health & Territory Research group of the University of Seville, together with a multidisciplinary team including patient representatives, rheumatologists, and health researchers. Data were collected in two phases, the first (P1) between April-July 2020 and the second (P2) between February-April 2021. Demographics, health behaviors, employment status, access to healthcare services, disease characteristics, WHO-5 Well-Being Index and Hospital Anxiety and Depression Scale (HADS) were collected. Workplace conditions including internet connection, computer, workstation, webcam, telephone, light, noise, calmness, and temperature were assessed (on a scale of 0 to 5, being 5 the best condition). Pearson’s Chi-square test, Kruskal-Wallis and Mann-Whitney test were used to explore association with working from home.

Results There were a total of 3,802 participants across both phases (mean age 52.6 (P1) vs. 55.0 years (P2); 80.2% female (P1) vs 83.7% (P2); 69.6% married (P1) vs 68.3% (P2), 48.6% university educated (P1) vs 47.8% (P2), 34.7% employed (P1) vs 38.1 (P2)). Most prevalent RMD was axial spondyloarthritis in P1 (37.2%), and rheumatoid arthritis in P2 (53.1%). Rates of working from home were consistent (P1: 39.8% vs P2: 39.9%).

In P2, 37.4% of those working from home had a home office, while 38.5% worked from their living room or kitchen. Work-related aspects at home were assessed, with the worst rated being the workplace (3.2) and the best being the computer (4.0). Compared to patients with good well-being and without anxiety and depression, patients with poorer well-being and at higher risk of anxiety or depression reported more frequently poorer rating of work from home issues, such as workplace (3.0 vs. 3.5; 2.9 vs. 3.6; 2.9 vs. 3.4; p<0.001), light (3.6 vs. 4.0; 3.6 vs. 4.0; 3.5 vs. 4.0; p<0.001), noise (3.3 vs. 3.8; 3.2 vs. 3.9; 3.2 vs. 3.8; p<0.001) and calmness (3.3 vs. 4.0; 3.2 vs. 3.9; 3.1 vs. 3.9; p<0.001; Table 1).

Conclusion Patients with poorer well-being, at higher risk of anxiety or depression reported poorer ratings of workspace-related aspects. Therefore, although work from home has helped to reduce the spread of the COVID-19 pandemic, the conditions under which RMD patients work from home must be considered, as these may affect the well-being and mental health of an already vulnerable group. It is necessary to assess the conditions of home-based workspaces - especially for workers with chronic diseases such as RMD patients - to ensure that it is feasible to work from home and that employers provide the necessary equipment for healthy work.

Acknowledgements This study was supported by Novartis Pharma AG. We would like to thank all patients that completed the survey as well as all of the patient organisations that participated in the REUMAVID study including: the Cyprus League for People with Rheumatism (CYLPER) from Cyprus, the Association Française de Lutte Anti-Rhumatismale (AFLAR) from France, the Hellenic League Against Rheumatism (ELEANA) from Greece, the Associazione Nazionale Persone con Malattie Reumatologiche e Rare (APMARR) from Italy, the Portuguese League Against Rheumatic Diseases (LPCDR), from Portugal, the Spanish Federation of Spondyloarthritis Associations (CEADE), the Spanish Patients’ Forum (FEP), UNiMiD, Spanish Rheumatology League (LIRE), Andalusian Rheumatology League (LIRA), Catalonia Rheumatology League and Galician Rheumatology League from Spain, and the National Axial Spondyloarthritis Society (NASS), National Rheumatoid Arthritis (NRAS) and Arthritis Action from the United Kingdom.

Disclosure of Interests Marco Garrido-Cumbrera Grant/research support from: has a research collaboration with and provides services to Novartis Pharma AG, Victoria Navarro-Compán Grant/research support from: AbbVie, BMS, Janssen, Lilly, MSD, Novartis, Pfizer, Roche and UCB, Laura Christen Employee of: Novartis Pharma AG, José Correa-Fernández: None declared, Helena Marzo-Ortega Speakers bureau: AbbVie, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Takeda and UCB, Consultant of: AbbVie, Celgene, Janssen, Lilly, Novartis, Pfizer and UCB, Grant/research support from: Janssen and Novartis