Your browser doesn't support javascript.
POST COVID-19 RHEUMATIC and MUSCULOSKELETAL DISEASES
Annals of the Rheumatic Diseases ; 81:1691, 2022.
Article in English | EMBASE | ID: covidwho-2009075
ABSTRACT

Background:

Recent data suggests that SARS-Cov-2 can alter self-tolerance and trigger autoimmune responses through cross-reactivity with host cells;therefore it can lead to late autoimmune and infammatory manifestations. With regard to rheumatic and musculoskeletal diseases (RMDs), medical literature displays sporadic case reports describing a variety of conditions diagnosed after COVID-19, but it remains still unclear what are the most common problems in patients presenting to rheumatology clinic following COVID-19 disease.

Objectives:

To describe the pattern of post-COVID-19 RMDs in a consecutive group of patients from rheumatology outpatient clinic.

Methods:

We have performed an observational descriptive study of a group of adult patients who received a new diagnosis of RMD within a timeframe of 12 weeks after the confirmation of COVID-19. Data was collected based on clinical presentation, paraclinical pattern and radiological examinations.

Results:

The study included 23 patients who were consulted in rheumatology outpatient clinic and had post COVID-19 new onset joint, periarticular, bone or infammatory syndrome manifestations. The general characteristics of the study group were as follows mean age 45.5±11.3 (range 21-63) years and female to male ratio of 1.81. The majority of subjects consulted for joint symptoms (91.4%), in other cases reason for consultation was persistent low grade fever and fatigue (4.3%) and skin rash with dyspnea (4.3%). The mean duration of symptoms was 9.8±10.5 (range 1-42) weeks, and the time of onset after COVID-19 diagnosis was 4.9±4.1 (range 0-12) weeks. Concerning COVID-19 severity, it was established that in 60.9% it was mild, 17.4 %-moderate and 21.7%-severe. After clinical and paraclinical examination, the following diseases were diagnosed ReA, lupus like syndromes, avascular necrosis, new onset RA and new onset PsA. In 69.7% of patients were diagnosed with ReA, the clinical pattern being joint or periarticular involvement of the hand, knee and feet. In 13.0% cases patients had multisystemic involvement (myocarditis, pericarditis, skin rash, infammatory arthritis and/or low grade fever) and positive ANA and or dsDNA Ab, these cases were diagnosed as lupus like syndromes and followed a severe form of COVID-19. In 8.7% of patients who presented with non-infammatory hip pain, avascular necrosis was diagnosed, in both cases femoral head being the affected part. No be noted that patients with avascular necrosis had a severe form of COVID-19 disease and joint pain started later after COVID-19 diagnosis (10-12 weeks). In 4.3% of cases each, new onset RA and PsA were identifed.

Conclusion:

In the present study we have found that COVID-19 can be followed by a variety of RMDs. The most common symptom of patients presenting with RMD was joint pain. The most common disease was post-COVID ReA (69.7%). Avascular necrosis (8.7%) and lupus like syndromes (13.0%) were found in patients who experienced a severe form of COVID-19. More rarely, patients had new onset of rheumatoid arthritis (4.3%) or psoriatic arthritis (4.3%). Our findings suggest that during the COVID-19 recovery period patients might experience onset of RDMs;therefore, in the presence of joint symptoms or other manifestations suggesting an autoimmune disease, patients should be referred to a rheumatologist for careful clinical examination.
Keywords

Full text: Available Collection: Databases of international organizations Database: EMBASE Topics: Long Covid Language: English Journal: Annals of the Rheumatic Diseases Year: 2022 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: Databases of international organizations Database: EMBASE Topics: Long Covid Language: English Journal: Annals of the Rheumatic Diseases Year: 2022 Document Type: Article