#5-44E. The Diagnostic Gap: Tracking Post-Pandemic Rheumatic Disease Trends in England (Lancet Rheumatol, 2026)

Are we missing critical autoimmune rheumatic disease diagnoses in the wake of the COVID-19 pandemic? This population-level cohort study leveraged the OpenSAFELY platform to analyze electronic health records of over twenty-three million adults in England, comparing diagnostic rates before, during, and up to five years after the pandemic's onset. The key finding reveals a stark divergence in recovery: while rheumatoid arthritis, psoriatic arthritis, and giant cell arteritis still show substantial cumulative diagnostic deficits, axial spondyloarthritis diagnoses have actually surged beyond pre-pandemic levels, particularly in women. Critically, we must interpret these findings carefully, as this observational study's reliance on electronic records means changes in healthcare-seeking behaviors and clinical coding practices could confound the observed trends. For clinicians, these results underscore the urgent need for targeted case-finding strategies to identify the "missing" patients who went undiagnosed during health service disruptions, ultimately helping us prevent the irreversible physical and psychological damage associated with delayed intervention in daily practice.

Citation: Mark D Russell, et al. Trends in autoimmune rheumatic disease diagnoses before and after the COVID-19 pandemic in England: a population-based cohort study using OpenSAFELY. The Lancet Rheumatology. 2026. DOI: 10.1016/S2665-9913(26)00142-6

URL: https://doi.org/10.1016/S2665-9913(26)00142-6

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