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Clin Exp Rheumatol . Diagnosis of COVID-19 associated arthritis in patients with or without underlying rheumatic and musculoskeletal disease suppor

tetano

Editor, Senior Moderator
Clin Exp Rheumatol


. 2022 Jul 28.
doi: 10.55563/clinexprheumatol/an1yrh. Online ahead of print.
Diagnosis of COVID-19 associated arthritis in patients with or without underlying rheumatic and musculoskeletal disease supported by musculoskeletal ultrasound: a case series from three European centres


Dominik Vogler[SUP] 1 [/SUP], Piero Ruscitti[SUP] 2 [/SUP], Luca Navarini[SUP] 3 [/SUP], Roberto Giacomelli[SUP] 4 [/SUP], Annamaria Iagnocco[SUP] 5 [/SUP], Paula Hoff[SUP] 1 [/SUP], Gerd-Rüdiger Burmester[SUP] 1 [/SUP], Sarah Ohrndorf[SUP] 6 [/SUP]



Affiliations

Abstract

Objectives: The coronavirus disease 19 (COVID-19) pandemic concerns the field of rheumatology in many ways. Arthritis in conjunction with COVID-19 is increasingly reported. However, clinical data are still limited and there is lack of a detailed characterisation of COVID-19 associated arthritis by musculoskeletal ultrasound (MSUS). This case series reports different forms of COVID-19 associated arthritis supported by MSUS in patients with or without underlying rheumatic and musculoskeletal disease (RMD).
Methods: From March 2020 to July 2021, adult patients (n=10) with arthritis timely related to COVID-19 were assessed in three European centres by clinical and laboratory values and additionally MSUS.
Results: In the group without underlying RMD (n=6), two patients presented with polyarticular arthralgia during severe COVID-19, swelling was rarely seen and MSUS demonstrated arthritis only in a few joints affected. The other four patients showed arthritis four to 16 weeks after mild or moderate COVID-19 (without hospitalisation): polyarthritis (n=1), oligoarthritis of the upper and lower limb (n=2), and in one case, late-onset rheumatoid arthritis (LORA) was newly diagnosed. In the group with an underlying RMD (n=4), an increase of disease activity was reported by MSUS during mild and mild-moderate COVID-19. In general, MSUS often presented power Doppler (PD) positive synovitis and tenosynovitis.
Conclusions: In our patients without underlying RMD, arthritides associated with COVID-19 are comparable to the clinical picture of a reactive arthritis (ReA) or other virus-related arthritides (e.g. parvovirus B19). New onset or flares of RMD possibly triggered by COVID-19 are noteworthy.
 
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