Inflammatory Arthritis Associated with COVID-19 Vaccination

Abstract

COVID-19 vaccines have been shown to be highly efficacious in preventing symptomatic COVID-19 infections throughout the pandemic. There have been emerging cases of inflammatory arthritis occurring in close relation to COVID-19 vaccination. We illustrate a case of new-onset inflammatory arthritis 10 days after receiving their second Vaxzevria COVID-19 vaccine. The patient responded dramatically to prednisolone treatment but subsequently required hydroxychloroquine due to persistent inflammatory joint symptoms. Inflammatory arthritis is an increasingly recognized rare adverse effect of COVID-19 vaccination and clinicians should actively consider this in patients with new or flares of inflammatory joint disease.

New-Onset Rheumatic Immune-Mediated Inflammatory Diseases Following SARS-CoV-2 Vaccinations until May 2023: A Systematic Review

“…Among the patients with rheumatoid arthritis (RA), twelve [8,11,101,113,115,139,140,191] were seronegative, and nine [69,101,129,133,164,191,192] were seropositive for anti-cyclic citrullinated peptide (CCP) antibodies or rheumatoid factor (RF) or both. Among these, six patients [69,101,129,164,193] had both RF and CCP positives, and three patients [101,133,191] were only positive for RF.…”

“…Among these, six patients [69,101,129,164,193] had both RF and CCP positives, and three patients [101,133,191] were only positive for RF. The majority (seventeen patients, 80%) had polyarthritis presentation [8,11,101,113,115,129,164,191,192], whereas two had oligoarthritis [69,133] and another two had monoarthritis presentation [139,140]. A total of eighteen patients received corticosteroids, eleven patients received disease-modifying antirheumatic drugs (DMARDs), six received methotrexate [69,101,133,164,192], two received leflunomide [101,191], one received mycophenolate [11], three received HCQ [113,164,192], one received sulphasalazine [164], and four patients received biologic drugs: tocilizumab for one [133], etanercept for one [115], adalimumab for one [101], and golimumab for one patient [101].…”

“…The majority (seventeen patients, 80%) had polyarthritis presentation [8,11,101,113,115,129,164,191,192], whereas two had oligoarthritis [69,133] and another two had monoarthritis presentation [139,140]. A total of eighteen patients received corticosteroids, eleven patients received disease-modifying antirheumatic drugs (DMARDs), six received methotrexate [69,101,133,164,192], two received leflunomide [101,191], one received mycophenolate [11], three received HCQ [113,164,192], one received sulphasalazine [164], and four patients received biologic drugs: tocilizumab for one [133], etanercept for one [115], adalimumab for one [101], and golimumab for one patient [101]. Nine patients had corticosteroids as monotherapy [8,11,129,139,140,191], another ten received prednisolone and DMARD in combination, and one patient with intolerance to methotrexate and leflunomide received adalimumab [101].…”

Long-term rheumatoid manifestations as a consequence of COVID-19 and/or vaccination: A case report after a 2-year follow-up

“…In addition to the possibility of late COVID-19 manifestation, it has been shown that vaccination might trigger some related symptoms. The majority of vaccine inflammatory arthritis onset occur up to seven days post administration, however, they can occur later as well [ 18 ].…”