Long COVID from rheumatology perspective - a narrative review

Abstract

Long-term sequel of acute COVID-19, commonly referred to as long COVID, has affected millions of patients worldwide. Long COVID patients display persistent or relapsing and remitting symptoms that include fatigue, breathlessness, cough, myalgia, arthralgia, sleep disturbance, cognitive impairment and skin rashes. Due to the shared clinical features, laboratory and imaging findings, long COVID could mimic rheumatic disease posing a diagnostic challenge. Our comprehensive literature review will help rheumatologist to be aware of long COVID manifestations and differentiating features from rheumatic diseases to ensure a timely and correct diagnosis is reached.

Keywords: Long COVID; Post COVID-19 condition; Post-COVID-19 syndrome; Rheumatology; Systemic autoimmune rheumatic diseases.

Fig. 1

Flowchart study selection of long COVID

Fig. 2

Flowchart of the management of a patient presenting with long COVID. (anti-CCP anticyclic-citrullinated protein, CFS chronic fatigue syndrome, CK creatinine kinase, CT computed tomography, CXR chest X-ray, Dx diagnosis, ENA extractable nuclear antigen, ESR erythrocyte sedimentation ratio, FM fibromyalgia, H/O history of, Ix investigation, PCR polymerase chain reaction, RF rheumatoid factor, SOB shortness of breath, + ve positive, *in presence of contact with confirmed or suspected COVID-19 within 2 weeks of onset symptoms.)