Long COVID and rheumatology: Clinical, diagnostic, and therapeutic implications

Calabrese, Cassandra; Kirchner, E; Calabrese, Leonard H.

doi:10.1016/j.berh.2022.101794

Cited by 19 publications

(13 citation statements)

References 67 publications

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“…Other manifestations of Long COVID appear highly pathogen-specific such as anosmia and ageusia which were quite common with pre-Omicron strains but have since become relatively rare 2. Far more common, however, and the focus of this Viewpoint, are those individuals who, following mild-to-moderate COVID-19, develop a heterogeneous and diverse collection of largely unexplained symptoms dominated by fatigue (often with features of postexertional malaise), neurocognitive dysfunction often referred to as ‘brain fog’, sleep disturbances and varying forms of pain including myalgia, arthralgia, headache, chest pain and beyond 1 3. As the international research community attempts to unravel Long COVID, much has been written regarding the similarities with myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS),1 2 yet relatively little has been discussed regarding the similarly strong parallels to a condition with a rich background of clinical and basic research which is familiar to many in the rheumatology community: FM.…”

Section: Long Covid At a Glancementioning

confidence: 99%

Rheumatology and Long COVID: lessons from the study of fibromyalgia

Clauw

Calabrese

2023

Ann Rheum Dis

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Rheumatology, such as other subspecialties, has both a unique perspective to offer as well as an evolving role to play in the global COVID-19 pandemic. Our field has already contributed meaningfully to the development and repurposing of many of the immune-based therapeutics which are now standard treatments for severe forms of the disease as well as to the understanding of the epidemiology, risk factors and natural history of COVID-19 in immune-mediated inflammatory diseases. Still in evolution is our potential to contribute to burgeoning research efforts in the next phase of the pandemic: the syndrome of postacute sequelae of COVID-19 or Long COVID. While our field brings many assets to the study of Long COVID including our expertise in the investigation of chronic inflammation and autoimmunity, our Viewpoint focuses on the strong similarities between fibromyalgia (FM) and Long COVID. While one can speculate on how embracing and confident practising rheumatologists already are regarding these interrelationships, we assert that in the emerging field of Long COVID the potential lessons from the field of fibromyalgia care and research have been underappreciated and marginalised and most importantly now deserve a critical appraisal.

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Section: Long Covid At a Glancementioning

confidence: 99%

Rheumatology and Long COVID: lessons from the study of fibromyalgia

Clauw

Calabrese

2023

Ann Rheum Dis

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“…Evidence of systemic heightened autoimmunity may persist for weeks or months in hospitalized patients and is the hallmark of multisystem inflammatory syndrome in children. However, similar immunopathology has not been demonstrated in nonhospitalized patients with long COVID (8,9,32,35). As characteristic of FM and ME/CFS, long COVID has not been associated with the classic systemic autoantibodies or elevated acute phase reactants (40,41).…”

Section: Long Covid As a Disease Or A Syndrome Like Fm Or Me/cfsmentioning

confidence: 99%

“…Myalgias or arthralgias have been present in 50% to 90% of patients with long COVID, but there has been no evidence of synovitis or myositis (6,7). Anecdotal experience from rheumatologists at the Long COVID Clinic at the Cleveland Clinic noted that in over 2,000 patients, "virtually all have been non-inflammatory, with many bearing features of fibromyalgia" (8). In a comprehensive survey of more than 400 participants with self-reported long COVID, joint pain was reported by 60% and muscle pain by 57% (9).…”

Section: Similar Symptoms Of Fm and Me/cfs In Long Covid Syndromementioning

confidence: 99%

Applying Lessons From Rheumatology to Better Understand Long COVID

Goldenberg

2023

Arthritis Care & Research

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Long COVID can sometimes be attributed to organ damage and well‐characterized pathophysiology, but more often there is no evidence of organ damage or abnormal biomarkers. This is most evident in patients with mild to moderate initial SARS‐CoV‐2 infection who were not hospitalized. Their persistent symptoms are strikingly similar to those of fibromyalgia (FM) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), including fatigue, post exertional malaise, myalgias/arthralgias, sleep and cognitive disturbances in 50‐100% of cases.Analogous pathophysiologic pathways in FM, ME/CFS and long COVID include host‐microbial interactions in the absence of direct tissue invasion, an absence of systemic autoimmunity, but evidence for immune dysregulation, as well as autonomic, peripheral, and central nervous system dysfunction. Current treatment of long COVID has been based on multidisciplinary management recommended for FM and ME/CFS but has been formalized and widely available by funding for nation‐wide long COVID clinics. Long COVID and its treatment should be distinguished by the presence or absence of organ damage. The acknowledged role of patient engagement in research and open dialogue regarding work and disability noted in long COVID may have meaningful impact on patients with FM and ME/CFS. Hopefully, advances in long COVID basic research will aid in understanding FM and ME/CFS and rheumatologists should be involved in such research and patient care.image

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“…at/Corona/allgemeine-informationen/ long-covid.html). Schätzungen zufolge leiden etwa 10 % der COVID-19-Überlebenden an Long COVID [1,2]. Unabhängig von Patienten mit Long COVID wird aber zunehmend von Patienten berichtet, bei denen nach einer COVID-19-Infektion Symptome einer chronischen entzündlich-rheumatischen Erkrankung beginnen [3][4][5].…”

Section: Rheuma Nach Covid-19-infektion Oder Impfungunclassified

“…Die häufigsten Beschwerden sind andauernde Müdigkeit (Fatigue), anhaltendes Krankheitsgefühl („post-exertional malaise“, PEM) mit eingeschränkter körperlicher und geistiger Leistungsfähigkeit, Kurzatmigkeit, Geruchs- und Geschmacksstörungen und andere Symptome wie Gelenk- und Muskelschmerzen ( https://www.sozialministerium.at/Corona/allgemeine-informationen/long-covid.html ). Schätzungen zufolge leiden etwa 10 % der COVID-19-Überlebenden an Long COVID [ 1 , 2 ]. Unabhängig von Patienten mit Long COVID wird aber zunehmend von Patienten berichtet, bei denen nach einer COVID-19-Infektion Symptome einer chronischen entzündlich-rheumatischen Erkrankung beginnen [ 3 – 5 ].…”

unclassified

Rheuma nach COVID-19-Infektion oder Impfung

Herold

2023

J. Miner. Stoffwechs. Muskuloskelet. Erkrank.

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ZusammenfassungSowohl nach COVID-Infektion als auch nach ein oder mehreren COVID-Impfungen können rheumatische Beschwerden beginnen. In beiden Fällen scheint der Mechanismus ähnlich zu sein und mit dem Coronavirus oder seinen spezifischen Folgen zusammenzuhängen. Zumeist wird von einer reaktiven Arthritis gesprochen, wenngleich die Bezeichnung COVID-19-assoziierte Arthritis für das Beschwerdebild eher zutreffen dürfte. In Relation zur Zahl der COVID-Infizierten und der COVID-geimpften ist die Zahl der Fälle, in denen es zu COVID-assoziierten Beschwerden kommt, außerordentlich gering und die Prognose scheint eher gut zu sein.

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Long COVID and rheumatology: Clinical, diagnostic, and therapeutic implications

Cited by 19 publications

References 67 publications

Rheumatology and Long COVID: lessons from the study of fibromyalgia

Rheumatology and Long COVID: lessons from the study of fibromyalgia

Applying Lessons From Rheumatology to Better Understand Long COVID

Rheuma nach COVID-19-Infektion oder Impfung

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