COVID-19 in Patients with Systemic Inflammatory Diseases: Impact on Disease Activity.

INTRODUCTION: COVID-19 pandemic, an international emergency, raised concerns about the interaction of this infection and disease-modifying drugs used in the treatment of Systemic inflammatory diseases (SID). Understanding the relationship between COVID-19 and disease activity is crucial to adapt the treatment. AIM: The aim of our study was to determine the impact of COVID-19 on the disease activity of rheumatic diseases. PATIENTS AND METHODS: We performed a cross-sectional study, including patients with SID (rheumatoid arthritis (RA) and spondyloarthritis (SpA)). Disease activity was evaluated during the last check-up before COVID-19 and within the period of 6 months after the infection. Activity scores were assessed with Disease Activity Score (DAS28) for RA and Ankylosing Spondylitis Disease Activity Score (ASDAS) for SpA. Correlation and regression coefficients were used to evaluate associations among the variables. RESULTS AND DISCUSSION: Totally, thirty-two patients were included; twenty followed for RA and twelve for axial SpA. The mean disease duration of the underlying rheumatic disease was 10.2 years (2-30). RA was seropositive and erosive in 61% and 31%, respectively. Seventeen patients were on csDMARDs: 14 were on Methotrexate and three patients were on Salazopyrine. Ten patients (31%) were treated with bDMARDs; Tumor necrosis factor (TNF)-alpha inhibitors were used in eight cases. Rituximab and secukinumab were prescribed for one patient each. In 70%, COVID-19 was pauci-symptomatic. A severe form with a need for hospitalization was noted in 9%. Two patients were admitted to the intensive care unit (ICU). Overall, treatment with DMARDs was interrupted in all cases: when COVID-19 symptoms began in 82% and when PCR was positive in 18%. Both RA and axial SpA were not active after a mean period of 6 months after COVID-19 infection (p = 0.818 and p = 0.626, respectively). CONCLUSION: Although our patients interrupted their DMARDs, our study demonstrates that disease activity as assessed by ASDAS and DAS28 in SpA and RA remained unchanged after COVID-19.

Can SARS‐CoV‐2 infection trigger rheumatoid arthritis? A case report

Inflammatory arthritis has been reported after SARS‐COV‐2 infection. We present a case of a 38‐year‐old female patient who developed polyarthralgia 1 month after SARS‐COV‐2 infection. Musculoskeletal examination was significant for synovitis of hands and wrists. Antinuclear antibody (ANA), rheumatoid factor (RF), and anti‐cyclic citrullinated peptide (CCP) antibodies were positive. Magnetic resonance imaging of the hands showed synovitis of the metacarpophalangeal joints and proximal interphalangeal joints of the hands, wrist joints, and tendinitis with tenosynovitis. The patient was diagnosed with seropositive nonerosive rheumatoid arthritis (RA) and initiated on therapy using nonsteroidal anti‐inflammatory agents and disease‐modifying anti‐rheumatic drug methotrexate leading to an improvement in symptoms. Cases of autoimmune and auto‐inflammatory diseases triggered after COVID‐19 have been reported. We report the case of a 38‐year‐old female patient who developed seropositive, nonerosive rheumatoid arthritis (RA) one month after SARS‐CoV‐2 infection.

Can SARS-CoV-2 infection trigger rheumatoid arthritis? A case report.

Inflammatory arthritis has been reported after SARS-COV-2 infection. We present a case of a 38-year-old female patient who developed polyarthralgia 1 month after SARS-COV-2 infection. Musculoskeletal examination was significant for synovitis of hands and wrists. Antinuclear antibody (ANA), rheumatoid factor (RF), and anti-cyclic citrullinated peptide (CCP) antibodies were positive. Magnetic resonance imaging of the hands showed synovitis of the metacarpophalangeal joints and proximal interphalangeal joints of the hands, wrist joints, and tendinitis with tenosynovitis. The patient was diagnosed with seropositive nonerosive rheumatoid arthritis (RA) and initiated on therapy using nonsteroidal anti-inflammatory agents and disease-modifying anti-rheumatic drug methotrexate leading to an improvement in symptoms.