Acute arthritis associated with COVID-19

Abstract

Coronavirus infection (COVID-19) is usually characterized by respiratory symptoms, but can have a wide range of clinical manifestations. The growing interest is focusing on the short-term and long-term immune-mediated sequelae triggered by the COVID-19. One of these complications is post-infectious arthritis, classified by some authors as reactive. This paper summarizes and analyzes 25 clinical cases of COVID-19-associated acute arthritis that have been published from January 2020 to November 2021. The mean age of the patients was 46 14 years, with the disease being more prevalent in men than in women. Joint lesions were mono- or polyarticular, with predominant involvement of the joints of the lower extremities. HLA-B27 antigen was determined in 13 of 25 patients and was found in 30% of cases. Like many other viral diseases, the severe acute respiratory syndrome 2 caused by coronavirus can act as a causative agent or a trigger in the development of inflammatory arthritis in predisposed individuals. The post-infectious arthritis should be differentiated from diseases that can manifest with a similar clinical presentation, which requires a complex of laboratory and instrumental studies. Non-steroidal anti-inflammatory drugs and glucocorticosteroids are successfully used in the treatment. The number of cases of post-COVID-19-arthritis is increasing, which urges further studies of its pathophysiology, diagnosis and treatment regimens.

Keywords

• covid-19
• sars-cov-2
• post-infectious arthritis
• acute arthritis
• spondyloarthritis
• rheumatic diseases
• molecular mimicry