The article presents a clinical case of systemic scleroderma and polymyositis in a young female patient. Notable is a rather rapid development of symptoms beginning with Raynaud’s syndrome, scleroderma skin lesion, and visceral pathology against the background of immunologic activity. Along with this, there were signs of polymyositis: weakness of proximal muscle groups, high indices of muscle enzymes, and positive electromyographic data. After SARS-CoV-2 vaccination, the patient noted a worsening of her general condition, increased muscle weakness and the appearance of new symptoms such as dysphagia, dysphonia, enlarged cervical lymph nodes, shortness of breath, and cough. The examination revealed vocal fold paralysis, paresis of the right side of the larynx and soft palate, and pulmonary hypertension. The results of the examination of the muscular component implied a primary muscular lesion.

The article presents the results of a clinical observation of a case of the onset of axial spondyloarthritis in an elderly woman which developed against the background of the new coronavirus infection. The difficulties of the diagnostic search and, as a consequence, the selection of adequate therapy in combination with the patient’s post-COVID period and the onset of immuno-inflammatory disease are described. The characteristics of the clinical course and functional features of the patient are given. The issues of differential diagnosis between immuno-inflammatory disease, infectious and paraneoplastic processes are considered. Colonoscopy gave new data on the presence of Crohn’s disease in the patient and allowed excluding the oncological process, serving as a reason for further diagnostic search for spondyloarthritis. The revealed laboratory and instrumental changes made it possible to diagnose axial spondyloarthritis in this patient.