Reactive Arthritis Post-SARS-CoV-2

Ouedraogo, Faizal; Navara, Rachita; Thapa, Rusha; Patel, Kunj

doi:10.7759/cureus.18139

Cited by 11 publications

(28 citation statements)

References 19 publications

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“…In the present case, the WBC count in the SF at the first visit was much higher than that of the previous reports [ 2 , 4 , 6 ]. Few reports describing SF findings of post-COVID-19 arthritis showed WBC counts less than 20,000/μL.…”

Section: Discussioncontrasting

confidence: 86%

“…Reports of post COVID-19 ReA have been gradually increasing during the COVID-19 pandemic. Recently, COVID-19 has been reported to affect angiotensin-converting enzyme 2 receptors in the gastrointestinal tract, which weakens the gut immune function [ 4 ]. ReA usually manifests as arthritis following genitourinary or gastrointestinal infections [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

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Surgically treated reactive arthritis of the ankle after COVID-19 infection: A case report

Shimoyama

Teramoto

Murahashi

et al. 2022

Journal of Infection and Chemotherapy

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A 37-year-old man developed right ankle pain and swelling six days after being diagnosed with coronavirus disease (COVID-19). Despite conservative treatment, his ankle symptoms persisted. Magnetic resonance imaging and computed tomography showed synovial hypertrophy and bone erosion in the ankle. Following arthroscopic synovectomy, performed 69 days after the COVID-19 diagnosis, the pain improved significantly. The clinical course was consistent with that of reactive arthritis following severe acute respiratory syndrome coronavirus 2 infection. The pathological findings resembled rheumatoid nodules. The bone erosion may have originated from the inflammatory pathway, which resembles the mechanism of rheumatoid arthritis.

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Section: Discussioncontrasting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Surgically treated reactive arthritis of the ankle after COVID-19 infection: A case report

Shimoyama

Teramoto

Murahashi

et al. 2022

Journal of Infection and Chemotherapy

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“…The overwhelming majority of patients did not have a personal history of preexisting joint symptoms or autoimmune disease. Pertinent comorbidities included preexisting RA in one of the cases described by Alivernini et al 9 as well as one of the cases described by Derksen et al, 17 gout with recurrent acute arthritis in three of the cases described by Lopez-Gonzalez et al, 29 gout in each of the cases described by Ouedraogo et al 35 and Shimoyama et al, 40 unspecified recurrent acute arthritis in one of the cases described by Lopez-Gonzalez et al, 29 remote history of septic arthritis in one of the cases described by Sinaei et al, 42 chronic intermittent monoarticular joint pain in the case described by Kuschner et al, 27 sarcoidosis in one of the cases described by Derksen et al, 17 and autoimmune hypothyroidism in two cases described by Colatutto et al. 14 A comprehensive list of the comorbidities reported for each patient can be found in Table 1 .…”

Section: Resultsmentioning

confidence: 96%

The development of inflammatory arthritis following SARS-CoV-2 infection: a systematic review of the literature

et al. 2022

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Background Given the widespread impact of COVID-19, it is important to explore any atypical presentations and long-term sequelae associated with this viral infection, including the precipitation of inflammatory arthritis. Objective To identify and summarize clinical reports of acute inflammatory arthritis associated with COVID-19. Methods A systematic review of the PubMed (MEDLINE), Google Scholar, and Cochrane Central databases through January 31, 2022 was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The inclusion criteria were: human subjects and English language. Data extraction and qualitative synthesis of the demographics, clinical presentations, treatments, and outcomes were performed. Quality assessment was performed using the Joanna-Briggs Institute critical appraisal tools. Results A total of 37 articles collectively describing the cases of 54 patients were included. The mean age was 48.2 years (6-78 years). 53.7% of patients were male and 46.3% were female. The onset of articular symptoms varied considerably, and the majority of cases were described as polyarticular (29). The classification of inflammatory arthritis in the included studies was as follows: reactive (19), post-viral (13), new-onset rheumatoid arthritis (RA) (8), crystal-proven arthropathy flare (4), acute viral (2), new-onset psoriatic arthritis (2), flare of preexisting RA (2), and other (4). Arthritis treatment regimens varied but consisted largely of NSAIDs and corticosteroids with most patients experiencing improvement or resolution of their joint symptoms. Conclusion There is limited low-level evidence suggesting that patients may develop acute arthritis during or after SARS-CoV-2 infection. This review highlights the need for further research to elucidate the relationship between COVID-19 and the development of inflammatory arthritis.

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“…Except for two patients aged 14 and 16 years,15 16 all were adult patients, and the ages ranged from 27 years17 18 to 73 years 19. Half of the patients (13/26) were male 15 17 19–29. The time of occurrence of arthritis after COVID-19 varied between cases.…”

Section: Resultsmentioning

confidence: 99%

COVID-19-associated arthritis: an emerging new entity?

2022

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The current COVID-19 pandemic raises several clinical challenges. Cases of COVID-19-associated arthritis have been reported, and inconsistently described as either COVID-19 viral arthritis or COVID-19 reactive arthritis. We aimed to review all the reported cases of ‘COVID-19-associated arthritis’, which we propose, is a better term to define the entire spectrum of new-onset arthritis believed to be associated with SARS-CoV-2 infection. We performed a systematic literature review using MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews to search for articles published up to 13 December 2021. We included cohort studies, case series and case reports describing patients diagnosed with COVID-19 reactive or viral arthritis by a physician, irrespective of fulfilment of classification criteria. To identify relevant studies, medical subject headings and keywords related to ‘COVID-19/SARS-CoV-2 infection’ and ‘reactive arthritis’ were used. Our search retrieved 419 articles, of which 31 were included in the review. A total of 33 cases were reported in these 31 articles, the majority being adults (28/33=85%) with peripheral joint involvement (26/33=79%). Most of the patients responded well to treatment and the disease was self-limiting. These 33 case reports describe a possible causal relationship between exposure to SARS-CoV-2 and the onset of arthritis. However, since these cases were reported during a pandemic, other aetiologies cannot be fully excluded. The exact mechanism through which SARS-CoV-2 might trigger arthritis is not fully understood and robust epidemiological data to support a causal relationship are still lacking.

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Reactive Arthritis Post-SARS-CoV-2

Cited by 11 publications

References 19 publications

Surgically treated reactive arthritis of the ankle after COVID-19 infection: A case report

Surgically treated reactive arthritis of the ankle after COVID-19 infection: A case report

The development of inflammatory arthritis following SARS-CoV-2 infection: a systematic review of the literature

COVID-19-associated arthritis: an emerging new entity?

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