The interplay between COVID-19 and rheumatic diseases, particularly arthritis, has been a subject of extensive research and discussion. Up to 45% of individuals with rheumatic diseases, including rheumatoid arthritis and other chronic autoimmune disorders that cause inflammation, experience persistent symptoms associated with long COVID 28 days after acute infection with SARS-CoV-2. This highlights the risk of more severe disease in patients with rheumatic conditions.
Symptoms of reactive arthritis, such as sudden onset joint pain and swelling often in multiple joints, can develop after COVID-19. This condition raises concerns due to the shared clinical features, laboratory, and imaging findings between long COVID and rheumatic diseases, posing a significant diagnostic challenge. A comprehensive literature review emphasizes the need for rheumatologists to be aware of long COVID manifestations and its differentiating features from rheumatic diseases, ensuring timely and correct diagnoses.
Furthermore, the incidence of long COVID is higher in people with non-rheumatic autoimmune diseases (7.3%) but lower than in autoimmune arthritis. A Canadian survey of 170 people with arthritis reported many experiencing worsening symptoms after COVID-19 infection. This connection is further supported by reports of arthralgia and arthritis post SARS-CoV-2 infection in patients negative for rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA).
Studies have also noted the presence of autoantibodies in COVID-19 patients, including anti-cardiolipin, anti-β2-glycoprotein I, and antinuclear antibodies. The occurrence of ACPA and flaring of rheumatoid arthritis (RA) after SARS-CoV-2 infection have been described, although the frequency of ACPA remains uncertain.
People with rheumatoid arthritis (RA) face a higher risk of infections, including COVID-19. The highly infectious nature of the virus, spreading through airborne respiratory droplets, poses a significant threat to this group. It was initially unclear whether individuals with rheumatic diseases would be at increased risk during the COVID-19 pandemic, but recent findings suggest a heightened risk of complications. COVID-19 vaccines are recommended for people with rheumatoid arthritis to mitigate these risks. Additionally, ambient respiratory viral infections have been linked with an increased number of rheumatoid arthritis cases, particularly in women and older patients, suggesting that respiratory viral infections might be an environmental risk factor for the development of rheumatoid arthritis.
For more detailed insights, readers can explore further information from various authoritative sources. Visit Harvard Medical School for a clue into long COVID in patients with rheumatic diseases, or check out Medical News Today for an article on arthritis after COVID-19. A comprehensive narrative review from a rheumatology perspective on long COVID can be found at PubMed Central. The Arthritis Foundation offers insights into seeking clues to long COVID. For an understanding of arthritis after SARS-CoV-2 infection, refer to The Lancet Rheumatology.
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