Introduction: SARS-CoV-2 causes more severe symptoms in most chronic diseases, and rheumatic disease is no exception. This study aims to investigate whether there is an association between the use of immunomodulatory medications, including conventional disease-modifying agents (csDMARDs), glucocorticoids, and biologic DMARDs, and outcomes such as hospitalization and lung involvement in patients with rheumatic disease with COVID-19. Methods: We performed a cross-sectional study on 177 COVID-19 cases with rheumatologic diseases using immunomodulatory drugs as their regular treatment. All patients were evaluated regarding their initial chest computed tomography (CT) scan, COVID-19 symptoms, and comorbidities. We ran predictive models to find variables associated with chest CT-scan involvement and hospitalization status. Results: CT findings showed lung involvement in 87 patients with chest CT-scan severity score (C-ss) of less than 8 in 59 (33%) and more than 8 in 28 (16%) of our patients. Of all patients, 76 (43%) were hospitalized. Hospitalized patients were significantly older and had more comorbidities (P = 0.02). On multivariate analysis, older age [odds ratio (OR) 1.90, 95% confidence interval (CI) 1.31-3.08] and comorbidity (OR 2.75, 95% CI 1.06-3.66) were significantly associated with higher odds of hospitalization (P = 0.03). On multivariate analysis, older age (OR 1.15, 95% CI 0.94-2.01), pulmonary diseases (OR 2.05, 95% CI 1.18-3.32), and treatment with csDMARDs (OR 1.88, 95% CI 0.37-1.93) were associated with higher C-ss (P = 0.039). Conclusions: This study found that advanced age and comorbidities, similar to the general population, are risk factors for hospitalization in patients with COVID-19 with rheumatic disorders. Administration of csDMARDs, older age, and pulmonary disorders were linked to increased risk of COVID-19 pneumonia in these individuals.

Although the safety and efficacy of vaccinations have been evaluated through clinical trials, medical experts and authorities are very interested in the reporting and investigation of adverse events following SARS-CoV-2 immunization in the general public. This article reports a 41-year-old man without history of underlying diseases, complaining of continuous morning stiffness and acute discomfort in his left elbow joint, 20 days after taking the first dosage of Sputnik V. The case was extensively studied, and a possible diagnosis of reactive arthritis was made.

Background: Fibromyalgia (FM) and osteoarthritis (OA) share common clinical properties and pathologic etiologies. In the current study we aim to assess the prevalence of overlapping FM in a population of knee OA patients and to evaluate the diagnostic performance of Western Ontario Macmaster (WOMAC) for FM in OA patients. Methods: In a single-center observational study we recruited a consecutive sample of 100 knee osteoarthritis. The OA patients were assessed for pain, stiffness and function using WOMAC and for possible FM diagnosis using ACR 2010 diagnostic criteria. In order to find independent predictors for fibromyalgia diagnosis, univariate and multivariate logistic regression analyses were utilized. The results regression analysis was used to build the final prediction model. Receiver-operating characteristic (ROC) curves and Youden's J index were used to identify the best cutoff values for predictor parameters of fibromyalgia. Results: In a population of 100 OA patients in this study, 41 had fibromyalgia based on ACR criteria. Age (mean of 55.43±8.94 vs. 51.4±8.59; P= 0.025), BMI (25.17±3.52 vs. 23.59 ±3.77; P= 0.03) and WOMAC score (46.19±14.10 vs. 35.69±11.19; P= <0.001) were significantly higher in patients with FM than patients without FM. Univariate analysis identified that the age, BMI and WOMAC score (Ps= 0.029, 0.041, and <0.001, respectively) are significantly associated with FM diagnosis. In multivariate analysis, WOMAC score (OR: 0.93 (95% CI 0.90–0.97), P< 0.001) was identified as independent predictors for diagnosis of FM. Using Receiving operator curve, the Area under the curve (AUC) of WOMAC score was 0.715 (95%CI: 0.614-0.817) and the optimum cutoff point for WOMAC score for diagnosis of FM was 43.5. Conclusion: It is concluded from this study that WOMAC scores > 43.5 are useful for suggesting FM as a secondary diagnosis in knee OA patients. Future studies are necessary to establish the results of the current study in a more general context, given the limited available evidence.

Background Inflammatory rheumatic diseases, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and systemic sclerosis (SSc), can cause cardiovascular complications in many cases. This study aimed to compare the ventricular and atrial functions of the heart between rheumatic patients and healthy controls using transthoracic echocardiography (TTE). Results The study was performed between 64 patients with mentioned rheumatic diseases and 64 age- and sex-matched healthy controls who all underwent detailed history-taking and TTE. Echocardiographic parameters were measured and compared between the two groups. TTE showed significant differences in many echocardiographic parameters. Left ventricular end-diastolic diameter, left ventricular end-systolic diameter, right atrium area, inferior vena cava diameter, and systolic pulmonary artery pressure were significantly higher in patients compared to the controls (P < 0.001). Left ventricular ejection fraction and right ventricular end-diastolic diameter were not statistically different between the groups (P > 0.05). Right ventricular septal strain, right ventricular free wall strain, average longitudinal right ventricular strain, tricuspid annular plane systolic excursion, right ventricular systolic myocardial velocity, and right ventricular fractional area change were lower in inflammatory rheumatic patients (P < 0.001). The subgroup analysis showed the same results’ trend for each disease and its own control group comparison. Conclusions Cardiac involvement in rheumatologic diseases, especially SLE, RA, and SSc, should always be taken into consideration as there may be silent changes affecting the overall prognosis of patients. Using TTE helps diagnose and make a treatment plan for cardiovascular complications in rheumatic disease patients.

Sarcoidosis is a complicated inflammatory disease characterized by the formation of non-caseating epithelioid granulomas in many organs. Herein, we reported a sarcoidosis case with multiple organ involvements and our diagnostic criteria and treatment plan.