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BackgroundThe management of patients with rheumatoid arthritis (RA) and novel coronavirus infection (NCI) is a significant problem due to the insufficient evidence base on this topic.ObjectivesTo study the features of the transferred NCI in patients with RA and its influence on the course of RA.MethodsFrom March 2020 to January 2022, 105 patients with RA who underwent NCI with a confirmed SarsCoV2 PCR result and/or X-ray computed tomography (CT) of the lungs were followed up. The age of the patients was 62 [55; 68] years, among them females - 84.7% (89 patients). The duration of RA at the time of NCI was 11 [6.5; 17.5] years. RA activity before NCI was low in 14 (13.3%) patients, moderate in 70 (66.6%), and high in 21 (20%) patients. The results of clinical and laboratory examinations were evaluated during the COVID-19, 1 and 3 months after it.ResultsThe symptoms of NCI in patients with RA were comparable in frequency and severity to the course of infection in the population. 30 (28.6%) patients had a mild course of COVID-19, 74 (70.5%) had a moderate course, and 1 had a severe course. Bilateral polysegmental pneumonia was detected in 75 (71.4%) patients.The outcome of COVID-19 in all patients is recovery. Analysis of the course of RA showed a significant increase in activity 1 and 3 months after NCI: DAS28 from baseline to COVID-19 3.59±1.13 to 4.87±1.27 points after 3 months, respectively. Of the total number of recovered patients, 38.0% of patients showed an increase in activity due to clinical and laboratory parameters.90.4% of patients noted the persistence or appearance of symptoms after undergoing NCI after 3 months, 45.7% had a combination of more than 3 different symptoms. The most common manifestations of asthenia in the form of a decrease in the quality of life (QOL) and working capacity.in 90.4% of patients: significant in 58.0% of people, insignificant in 32.4% of people. There was no significant correlation between RA activity and NCI severity. The second most frequent was the increase/appearance of pain in the joints - in 86.6% of respondents: significant in 72.3%, insignificant - 14.2%. Strengthening/appearance of muscle pain and/or headache and/or dysautonomia occurred in 44.7%. Appearance/intensification of shortness of breath and a decrease in exercise tolerance were noted by 36.1% of respondents: significant in 19.0% of people, insignificant in 17.1% of people. Among them, 64.8% (24) people with moderate severity, 35.2% (13) people with asymptomatic or mild NCI. Appearance/intensification of chest pain and/or palpitations was noted by 44.7% of people.ConclusionThe prevalence and course of COVID-19 in patients with RA did not differ from that in the general population. However, coronavirus infection has led to an increase in pain and an increase in RA activity, a long-term persistence of post-COVID manifestations in the form of musculoskeletal pain and asthenic symptoms with a deterioration in the quality of life. There was no significant correlation between RA activity and NCI severity. At the same time, specific respiratory symptoms occurred only in a third of patients.Disclosure of InterestsNone declared

Kazan State Medical University is one of the oldest medical universities in Russia, which has extensive experience in the international education market. The publication describes the features of postgraduate training of residents, first implemented on the basis of Kazan State Medical University in cooperation with the Royal College of Physicians and Surgeons of Canada. The experience of introducing a competency-­based educational approach into the residency program according to the CanMEDS system is described. Each competency underlying the CanMEDS principles is considered in detail.

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