Is There a Link Between COVID-19 and the Onset of Rheumatoid Arthritis?

The emergence of COVID-19 has led to a number of health complications and concerns, among which is the potential association with rheumatoid arthritis (RA). This connection is being investigated by researchers and clinicians across the globe. According to a 2022 review, reactive arthritis may occur in genetically predisposed individuals 1–4 weeks after various infections, including SARS-CoV-2. Notably, studies have reported the presence of autoantibodies in patients with COVID-19, such as anti-cardiolipin, anti-β2-glycoprotein I, and antinuclear antibodies. Instances of Anti-citrullinated protein antibodies (ACPA) and flaring of rheumatoid arthritis post-SARS-Cov-2 infection have also been observed. However, the frequency of ACPA occurrence post-infection remains uncertain.

In some cases, arthralgia and arthritis have manifested after SARS-CoV-2 infection even in patients who tested negative for rheumatoid factor (RF) and ACPA. For instance, a correspondence in The Lancet Rheumatology detailed a patient who developed arthritis following a COVID-19 infection.

A significant study published in Arthritis & Rheumatology in May 2021, which examined data from thousands of veterans, revealed that those with RA faced a 25% higher risk of contracting COVID-19 and a 35% greater risk of hospitalization or death from the virus compared to those without RA. This underscores the heightened vulnerability of individuals with rheumatoid arthritis during the pandemic.

People with RA are advised to be particularly vigilant against COVID-19, as their risk of infection is higher. The Healthline emphasizes the importance of taking extra precautions for those with RA to protect against the virus. Moreover, COVID-19 vaccines are strongly recommended for individuals with rheumatoid arthritis to mitigate their risk.

Emerging evidence suggests that respiratory viral infections can exacerbate autoimmune inflammatory conditions such as RA. Infections can also provoke flares in those with existing inflammatory arthritis. Consequently, there is a growing consensus that SARS-CoV-2 infection could potentially contribute to the development of RA or exacerbate existing RA symptoms. The interplay between COVID-19 and RA is a subject of ongoing research, as documented in various studies and publications.