The COVID-19 pandemic has caused significant psychological distress among patients with chronic diseases. Individuals receiving immunosuppressive therapies may experience increased anxiety due to perceived vulnerability to infection. This observational study aims to compare coronavirus-related anxiety levels in patients using biologic disease-modifying antirheumatic drugs (bDMARDs) and those using conventional disease-modifying antirheumatic drugs (cDMARDs).

Adult patients followed at the rheumatology outpatient clinic were contacted by telephone. After verbal consent was obtained, participants completed a patient information form and the Coronavirus Anxiety Scale. Anxiety levels and pandemic-related experiences were compared between treatment groups.

This observational cohort study was conducted at the Rheumatology outpatient clinic of Uludag University Faculty of Medicine. The study included adult patients diagnosed with rheumatic diseases who were receiving either biologic DMARDs (bDMARDs) or conventional DMARDs (cDMARDs).

During the COVID-19 pandemic period, patients were contacted by telephone and informed about the study. Verbal consent was obtained prior to data collection. Demographic and clinical characteristics were recorded using a structured patient information form.

Coronavirus-related anxiety was assessed using the validated Coronavirus Anxiety Scale. The primary objective was to compare anxiety scores between patients receiving biologic and conventional DMARD therapy. Secondary analyses explored patients' perceptions of infection risk and their experiences during the pandemic period.

No intervention, treatment modification, or additional clinical procedure was performed. The study design is observational, and all data were collected at a single time point.

Inclusion Criteria:

• Age ≥18 years
• Diagnosis of rheumatic disease
• Currently receiving biologic or conventional disease-modifying antirheumatic drugs (DMARDs)
• Followed at the rheumatology outpatient clinic during the COVID-19 pandemic period
• Provided verbal informed consent

Exclusion Criteria:

• Age <18 years
• Inability to complete telephone interview
• Cognitive impairment preventing reliable questionnaire response
• Refusal to participate

Adult patients with established rheumatic diseases under treatment with biologic or conventional DMARD therapy who were actively followed at a tertiary care rheumatology outpatient clinic during the COVID-19 pandemic.