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Response to: ‘Correspondence on ‘Onset of rheumatoid arthritis after COVID-19: coincidence or connected?’’ by Roongta et al
  1. Veerle F A M Derksen,
  2. Diane van der Woude
  1. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Veerle F A M Derksen, Department of Rheumatology, Leiden University Medical Center, Leiden 2300 RC, The Netherlands; v.f.a.m.derksen{at}

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We thank Roongta et al 1 for the interest taken in our work and for bringing this interesting case of seropositive rheumatoid arthritis (RA) after COVID-19 to the attention. They describe a patient who developed polyarthritis after proven SARS-CoV-2 infection, with seroconversion for both rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA) between 2 weeks and 6 months after infection. This raises the question whether seroconversion (becoming seropositive for ACPA and RF) might occur more often after COVID-19.

In our study, three out of five patients presenting with polyarthritis post-COVID were already autoantibody positive at first presentation to the rheumatologist, on average 8.3 weeks after COVID-19.2 Unfortunately, there was no serum available from the time before COVID-19 or from timepoints between SARS-CoV-2 infection and presentation to the rheumatologist, precluding any investigation into seroconversion after COVID-19 in these patients. However, detailed investigations into the characteristics of their ACPA response revealed the presence of multiple ACPA isotypes and …

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  • Handling editor Josef S Smolen

  • Contributors VFAMD drafted the manuscript and DvdW revised it critically.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Commissioned; internally peer reviewed.

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