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Case Reports
. 2023 Jun 27:24:e939870.
doi: 10.12659/AJCR.939870.

Inflammatory Arthritis After COVID-19: A Case Series

Siddhant Yadav  1 , Sara L Bonnes  1 , Elizabeth A Gilman  1 , Michael R Mueller  1 , Nerissa M Collins  1 , Ryan T Hurt  1   2   3 , Ravindra Ganesh  1
Affiliations
Case Reports

Inflammatory Arthritis After COVID-19: A Case Series

Siddhant Yadav et al. Am J Case Rep. .

Abstract

BACKGROUND Some patients who have recovered from acute infection with SARS-CoV-2 develop persistent symptoms that have been termed post-COVID syndrome (PoCoS). PoCoS can affect the musculoskeletal system, with arthralgia and myalgia being common. Preliminary evidence suggests that PoCoS is an immune-mediated condition that not only predisposes but also precipitates pre-existing inflammatory joint diseases such as rheumatoid arthritis and reactive arthritis. Here, we describe a series of patients who presented to our Post-COVID Clinic and were found to have inflammatory arthritis (reactive and rheumatoid arthritis). CASE REPORT We present 5 patients who developed joint pain several weeks after recovery from acute SARS-CoV-2 infection. These patients were seen in our Post-COVID Clinic and came from locations across the United States. All 5 patients were women, with age of diagnosis of COVID-19 disease between 19 and 61 years (mean 37.8 years). All patients presented with joint pain as the primary concern to the Post-COVID Clinic. Abnormal joint imaging was present in all patients. Treatments varied and included non-steroidal anti-inflammatory drugs, acetaminophen, corticosteroids, immunomodulators (golimumab), methotrexate, leflunomide, and hydroxychloroquine. CONCLUSIONS COVID-19 disease is a potential cause of inflammatory arthritis, with both rheumatoid arthritis and reactive arthritis demonstrated in our PoCoS population. Care must be taken to identify these conditions, as there are treatment ramifications.

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Conflict of interest statement

Conflict of interest: RTH is a consultant for Nestle Nutrition; RG is a consultant for Alpaca Health

Figures

Figure 1.
Figure 1.
Nuclear medicine scan showing increased radio tracer uptake of case 1. (A) Bilateral knees. (B) Bilateral wrists. (C) Left foot.
See this image and copyright information in PMC

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