CLINICAL CHARACTERISTICS of POST-COVID SYNDROME in PATIENTS with RHEUMATIC DISEASES in the REPUBLIC of TATARSTAN

ABSTRACT

Background: The management of patients with rheumatic diseases (RD) after a new coronavirus infection (NCI) is an urgent and signifcant problem. Objectives: To study post-COVID manifestations in patients with RD in the Republic of Tatarstan. Methods: From June 2020 to January 2022, 154 cases of NCI with confrmed Sar-sCoV2 PCR and/or X-ray computed tomography (CT) of the lungs in patients with RD were followed up. The study included 100 patients with RA, 36 patients with AS, 18 patients with PsA. RD activity before NCI was low in 56 (36.4%) patients, moderate in 90 (58.4%) patients, and high in 8 (5.2%) patients. Among the patients, 110 (71.5%) were female, 44 (28.5%) were male, the average age was 58 [46;64]. 28% (43) of patients had asymptomatic or mild NCI, 66.2% (102) had moderate NCI, and 5.8% (9) of people had severe NCI. Bilateral polysegmental pneumonia was detected in 111 (72.0%) patients. The results of clinical and laboratory examinations for RD were assessed before and 3 and 6 months after NCI. Patients underwent an in-depth survey 3 and 6 months after undergoing NCI for the presence of various symptoms, including manifestations of asthenia. Additionally, the severity of depression and anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS) and the Hamilton Scale. Results: 90.3% of patients noted the persistence or appearance of symptoms after undergoing NCI, and all of them had a combination of at least 3 different groups of symptoms. The most common asthenic manifestations were in the form of a decrease in the quality of life and working capacity in 85% of patients signifcant in 47.9% of people, insignifcant-in 38.7% of people. The second most frequent was the inten-sifcation/appearance of pain in the joints-80.5% of the respondents. Strengthening/appearance of muscle pain and/or headache and/or dysautonomia occurred in 47.4%. The appearance/intensifcation of shortness of breath and a decrease in exercise tolerance were noted by 30.5% of the respondents, while there was no connection with the severity of NCI, and half of the patients had a mild course of COVID 19. The appear-ance/intensifcation of chest pain and/or palpitations was noted by 20.8% of people. After 3 months, a decrease in the quality of life, manifestations of depression and anxiety were revealed 32.2% of people had a mild depressive disorder of moderate severity, 22.3% had clinically expressed anxiety and depression. Six months after the NCI, no abnormalities were detected on the Hamilton scale, and subclinically expressed anxiety/depression on the HADS scale. Conclusion: In most patients with RD, post-covid manifestations persist, primarily due to general constitutional, articular and cognitive symptoms. Manifestations of NCI itself in the form of respiratory and cardiovascular manifestations persist in less than a third of patients.