Gülhane Tıp Dergisi (Dec 2022)

Effects of COVID-19 on axial spondyloarthritis disease flare

  • Berkan Armağan,
  • Ebru Atalar,
  • Bahar Özdemir,
  • Özlem Karakaş,
  • Esra Kayacan Erdoğan,
  • Serdar Can Güven,
  • İsmail Doğan,
  • Orhan Küçükşahin,
  • Abdulsamet Erden

DOI
https://doi.org/10.4274/gulhane.galenos.2022.93723
Journal volume & issue
Vol. 64, no. 4
pp. 301 – 306

Abstract

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Aims:Rheumatological disease flares may occur after many infections. However, our knowledge of the post-Coronavirus disease-2019 (COVID-19) axial spondyloarthritis (SpA) flares and related factors is limited.Methods:We retrospectively assessed the axial SpA patients who had COVID-19. Demographic and clinical data were collected from the medical records. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was applied via telephone for pre- and post-COVID-19 SpA symptoms. An increase of ≥2 points in the BASDAI score or any new extra-articular manifestations were defined as SpA flares and SpA patients were grouped as flares and no-flare. Factors predicting SpA flare were also analyzed.Results:A total of 48 axial SpA patients were included in the study [age, mean±standard deviation (SD): 42.3±8.6 years; male: 65%]. Post-COVID-19 SpA flare was identified in 19 patients (40%), and new extra-articular manifestations were recorded in 6 patients (13%). Although the diagnosis of inflammatory bowel disease was more common in the flare group, the difference was not significant compared with that of the no-flare group. Other features of SpA and COVID-19 disease severity were similar between the flare and no-flare groups. In the flare group, the frequency of back pain (84% vs. 62%, p=0.091) and diarrhea (53% vs. 28%, p=0.080), and headache (84% vs. 52%, p=0.021) were higher than the no-flare group. No risk factor for a post-COVID-19 SpA flare could be identified.Conclusions:Post-COVID-19 flare was common in the axial SpA, and even new extra-articular manifestations could be reported. Although some clinical manifestations of COVID-19 were more common in patients with a flare, any predictive factor could not be identified among the study variables.

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