Rheumatoid arthritis and post-COVID-19 syndrome

Abstract

In the third year of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2, COVID-19) pandemic doctors are encountering a new pathology – post-COVID-19 syndrome (PCS, long covid). Musculoskeletal manifestations are among the most common and may present as myalgia, arthralgia, or arthritis. Currently, there is no generally accepted definition of the disease, its duration, classification, or diagnostic criteria, and no single view on the “content” of musculoskeletal manifestations of PCS. We have enough descriptions of the debut of rheumatoid arthritis (RA) after SARS-CoV-2. That is a question: it is a coincidence, or COVID-19 may be a trigger factor of RA? We thought that SARS-CoV-2 infection may be a trigger factor for new rheumatic musculoskeletal diseases, including rheumatoid arthritis or COVID-19 can unmask previously undetected RA. The occurrence of arthritis may be a sign of PCS with transient character. So arthritis in the post covid period may induce problems in differential diagnosis of rheumatic diseases.

How long is long COVID

“…It can be hypothesized that COVID‐19 may also trigger some (autoimmune) rheumatic diseases. Such a hypothesis is now supported by numerous observations, including our own 25 . We now offer our scheme with several scenarios of arthritis post‐COVID‐19 (Box 2).…”

“…Such a hypothesis is now supported by numerous observations, including our own. 25 We now offer our scheme with several scenarios of arthritis post‐COVID‐19 (Box 2 ).…”

Increasing autoimmune rheumatic diseases as a consequence of the COVID‐19 pandemic: A hypothesis or fact?

“…Back in 2020, we presented a hypothesis of COVID‐19 as a potential trigger of RA at the APLAR congress and published a related abstract in IJRD in October 2020. The same hypothesis, enriched with growing evidence, was discussed in our publication in 2022 4 . With time passing and accumulating evidence, similar hypotheses of COVID‐19‐induced RA were tested in large studies with crystallizing a scientific fact of the association.…”

“…The same hypothesis, enriched with growing evidence, was discussed in our publication in 2022. 4 With time passing and accumulating evidence, similar hypotheses of COVID-19-induced RA were tested in large studies with crystallizing a scientific fact of the association. Indeed, cohort studies in Taiwan, Germany, the UK, and South Korea, published in 2023, confirmed that SARS-CoV-2 infection was associated with increased ARD morbidity.…”

“…10 Osteonecrosis is yet another big issue amid the pandemic. 11,12 Several factors have been implicated in the pathophysiology of this debilitating complication which is associated with the infection and its irrational corticosteroid therapy. It seems plausible that the developing world, including central Asian countries, encounter an upsurge in osteonecrosis due to unjustified and widespread use of corticosteroids in COVID-19 patients in outpatient and inpatient settings.…”