Article Text

Download PDFPDF

AB0692 REACTIVE ARTHRITIS ASSOCIATED WITH COVID-19 INFECTION: A REVIEW
Free
  1. F. Alkindi1,
  2. K. Alseiari2,
  3. K. Al Naqbi3
  1. 1Tawam Hospital, Internal Medicine, Al Ain, United Arab Emirates
  2. 2Tawam Hospital, Internal Medicine, AlAin, United Arab Emirates
  3. 3Tawam Hospital, Rheumatology Department, AlAin, United Arab Emirates

Abstract

Background: The incidence of COVID-19 infection is increasing globally with high mortality rate. Cytokine release syndrome might contribute to extra-pulmonary manifestations such as acute kidney injury, venous thrombosis, neurological complications, hepatic and myocardial injury. Reactive arthritis is an emerging musculoskeletal (MSK) manifestation post COVID-19 infection. Reactive arthritis manifests as asymmetrical, oligoarthritis mainly involving peripheral or axial joints of lower extremities and associated with extra-articular manifestations.

Objectives: review the clinical presentation and management outcomes of COVID-19 associated reactive arthritis.

Methods: A literature research was conducted using PubMed and Google scholar for published abstracts, case reports, and studies from January 2020 to January 2021. We used search keywords” reactive arthritis”, “COVID-19 pneumonia”, “ SARS CoV2 infection”, and “Musculoskeletal”. Descriptive analysis was used due to small sample size.

Results: COVID-19 associated reactive arthritis is rarely reported. In review of literature, 10 cases were identified and we included our case of hip arthritis and avascular necrosis post COVID-19 infection. The mean age of cases (n=11) was of 42.8 years and 54.5 % of patients were males. (Table 1) The median duration of reactive arthritis diagnosis from COVID-19 infection ranged from 1 to 8 weeks. The severity of COVID-19 infection varied from mild (n= 6) to severe disease (n=2) per description in each reported case. Majority of the patients had oligoarticular involvement (2 to 4 joints) 45.5%, followed by monoarticular 36.4%, and polyarticular (> 4 joints) in 18%. Extra-articular manifestations were identified in 54.5% of patients including skin rash (erythematous itchy rash), urticarial rash, wrist tendinitis, Achilles enthesitis /tendonitis and balanitis. HLA-B27 testing was done in five patients and only one patient had a positive result. Plain radiographs were normal. Therapy provided of such cases were NSAIDS (n=4), steroids (oral, intra-articular) (n=1) or combination of steroids and NSAIDS (n=3) with favorable outcomes. The median reported follow up period ranged from 1.5 to 8 weeks.

Table 1.

Characteristics of the reported reactive arthritis cases post COVID-19 infection

Conclusion: Reactive arthritis is a rare MSK manifestations post COVID-19 infection. HLA-B27 positive testing might indicate severe and delayed form of arthritis with risk of recurrence. Larger studies are required to delineate the potential risk factors and long-term management outcomes for reactive arthritis associated with COVID-19 infection.

References: [1]Ono K, Kishimoto M, Shimasaki T, et al. Reactive arthritis after COVID-19 infection, RMD Open 2020;6:e001350. doi: 10.1136/rmdopen-2020-001350

Disclosure of Interests: None declared

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.