BACKGROUNDViral infections can not only be a trigger, but a worsening factor in the context of immune mediated rheumatic diseases (IMRDs). Thus, it is important to measure the impact of the new coronavirus SARS-CoV-2 infection, also known as COVID-19, in IRMDs' activity. This study has the objective of testing the association between SARS-CoV-2 infection and increase in disease activity in rheumatoid arthritis patients at the research center located in Manaus, Amazonas state. METHODSIt is a prospective observational study with a comparison group, based on the analysis of data from patients with rheumatoid arthritis of Project Reumacov, organized by the Brazilian Society of Rheumatology, localized in Manaus, Amazonas. Case and control groups included, respectively, patients with and without current or previous suspected SARS-CoV-2 infection according to Brazilian Ministry of Health criteria. There was a presential visit to collect the clinical disease activity index (CDAI) at the moment of inclusion. Previous CDAI was obtained from most recent records until six months before the presential visit, prioritizing a value before COVID-19 symptoms in the case group. It was analyzed the association between SARS-CoV-2 infection and increase in CDAI. Chi-squared and Fisher tests were used in the statistical analysis. The study was approved by the ethical committee.
BACKGROUNDSpondyloarthritis (SpA) is a group of inflammatory disorders that share clinical manifestations, genetic associations and pathogenic mechanisms, typically difficult to be diagnosed without evaluation by a rheumatologist. The SpA group includes ankylosing spondylitis (AS), psoriatic arthritis (PAs), reactive arthritis (ReA), enteropathic arthritis (EA) and undifferentiated spondyloarthritis (US). The difficulty in evaluating these diseases by nonrheumatologists and the lack of strategies for referring the suspected patient to the specialist result in a delay in the diagnosis of the disease and lead to subsequent investigations and unnecessary treatments, resulting in high costs and increased morbidity. METHODSObservational cross-sectional design based on the extraction and analysis of data from medical records of individuals affected by SpA, in the period from 2016 to 2020. RESULTSA total of 122 participants were included, 69.57% were male with a mean age of 46.76 ± 13.05 years; of which 78 participants had AS (63.93%), 37 PAs (30.33%), 4 EA (3.27%), 1 US (0.81%), 1 nonradiographic axial SpA (0.81 %) and 1 ReA (0.81%), with a mean time from onset of joint symptoms to diagnosis of the disease of 5.88 ± 8.36 years and with a mean time from onset of extra-articular symptoms to diagnosis of 4.09 ± 10.64 years. The predominant clinical form was axial in 54 (44.26%), peripheral in 31 (25.41%) and mixed in 37 (30.27%) of the participants. As for joint related clinical manifestations, there was the occurrence of: low back pain in 93 (76.23%), pain in the buttocks in 29 (23.77%), neck pain in 58 (47.54%), thigh pain in 26 (21.31 %), lower limb arthritis in 73 (59.83%), upper limb arthritis in 48 (39.34%), enthesitis in 39 (31.97%) and dactylitis in 19 (15.57%) of the participants. As for extra-articular clinical manifestations, the following were present in the sample: anterior uveitis in 18 (14.75%), inflammatory bowel disease in 8 (6.55%), psoriasis in 37 (30.33%) and urethritis in 7 (5.73%) participants. CONCLUSIONThere is a great delay in the diagnosis of SpA in the state of Amazonas, following global trends. However, the sample studied demonstrates that there are differences in the prevalence of clinical manifestations of the disease compared to international groups, which should be taken into account in the evaluation of patients suspected of SpA and in the creation of screening and referral tools.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.