Dear Editor, Today a frequently asked question is: Can vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) trigger rheumatic and musculoskeletal diseases? Several cases of arthritis have been reported after vaccination against SARS-CoV-2. 1-4 A few articles have investigated the safety of SPUTNIK-V; 5 there is only our one case of arthritis reported after this vaccination. 1 In our International Journal of Rheumatic Diseases paper about arthritis after vaccination against SARS-CoV-2 1 we wrote: 'Several patients with rheumatic diseases, treated in the Medical Center of Joint Diseases (MCJD), developed transient flares after receiving the COVID-19 vaccine'. A possible association between rheumatoid arthritis (RA) and influenza vaccination was previously reported in a cohort study; 6 however, there were no cases of seropositive RA after SPUTNIK-V vaccination in the literature. A heterologous recombinant adenovirus-based vaccine, Gam-COVID-Vac (Sputnik V, Gamaleya National Research Centre for Epidemiology and Microbiology), showed a good safety profile and induced strong humoral and cellular immune responses. 5 We would like to present the first case of new-onset seropositive (for rheumatoid factor [RF] and anti-citrullinated protein antibodies [ACPA]) RA after a single dose of SPUTNIK-V vaccine. We report the case of a 38-year-old Asian non-smoking woman with no history of chronic joint disease, infections, injuries, inflammatory back pain, morning stiffness, or joint swelling. The patient had no previous symptoms of SARS-CoV-2 infection; a serological anti-SARS-CoV-2 rapid test (COVID-19 IgG/IgM antibody test; Humasis,Germany) was negative. The patient received the first dose of the SPUTNIK-V vaccine on May 20, 2021 without developing a fever or adverse events. Twenty days later, | 1441 CORRESPONDENCE RA, though controlled studies are needed to prove this hypothesis.
In the third year of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2, COVID-19) pandemic doctors are encountering a new pathology – post-COVID-19 syndrome (PCS, long covid). Musculoskeletal manifestations are among the most common and may present as myalgia, arthralgia, or arthritis. Currently, there is no generally accepted definition of the disease, its duration, classification, or diagnostic criteria, and no single view on the “content” of musculoskeletal manifestations of PCS. We have enough descriptions of the debut of rheumatoid arthritis (RA) after SARS-CoV-2. That is a question: it is a coincidence, or COVID-19 may be a trigger factor of RA? We thought that SARS-CoV-2 infection may be a trigger factor for new rheumatic musculoskeletal diseases, including rheumatoid arthritis or COVID-19 can unmask previously undetected RA. The occurrence of arthritis may be a sign of PCS with transient character. So arthritis in the post covid period may induce problems in differential diagnosis of rheumatic diseases.
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