COVID-19-induced psoriatic arthritis: a case report

Abstract

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which may lead to uncontrolled immune activation and cytokine response in some. The pattern of pro-inflammatory cytokines is similar to that which has been observed to be involved in rheumatic diseases and target treatments. Viral arthritis is common with a wide variety in spectrum ranging from arthralgia to spurious and chronic arthritis. However, recent studies have demonstrated a correlation with endemic coronaviruses and increased risk of developing rheumatoid arthritis (RA). Cases are being identified that describe a post-COVID reactive; however, to date, no report has been published describing the onset of psoriasis and concomitant development of psoriatic arthritis after COVID-19 infection. We report an interesting case of psoriatic arthritis in a post-COVID-19 infection patient with review of the current literature.

Summarizing Evidence of Associations of COVID‐19 With a Future Diagnosis of Inflammatory Rheumatic and Musculoskeletal Diseases: A Rapid Review

“…There were 26 studies that proposed mechanisms related to the initiation of an autoimmune process. 6,10,15,[22][23][24]31,33,38,39,45,48,49,55,56,58,65,67,[69][70][71][73][74][75][76][77] Several studies proposed multiple possible autoimmune mechanisms. 10,24,31,39,45,48,55,73,77 Proposed mechanisms included molecular mimicry, 10,15,23,24,31,33,39,45,48,58,65,69,[73][74][75][76]…”

“…Alternatively, 25 separate studies considered that the development of an iRMD after COVID-19 may be the result of an excessive inflammatory response as opposed to an autoimmune process (ie, organ damage may be caused by high levels of inflammatory molecules, rather than autoreactive T and B cells). 6,24,37,47,49,56,58,63,[65][66][67][68][69][70]73,75,76,[78][79][80][81][82][83][84][85][86] Proposed mechanisms included a cytokine storm, 6,24,47,58,63,66,68,[82][83][84] neutrophil extracellular trap formation, 47,65,69,73,75 defects in dendritic cell function, 37,76 and disturbed glutathione metabolism. 80 Colonization of joint spaces and direct damage from SARS−CoV-2 virus.…”

“…There were 26 studies that proposed mechanisms related to the initiation of an autoimmune process 6,10,15,22–24,31,33,38,39,45,48,49,55,56,58,65,67,69–71,73–77 . Several studies proposed multiple possible autoimmune mechanisms 10,24,31,39,45,48,55,73,77 .…”

Long COVID in autoimmune rheumatic diseases

“…One of the proposed mechanisms of Long COVID-19 involves the formation of neutrophil extracellular traps (NETs) that may create the environment for autoantibody production with the exposure of intranuclear components of cells [ 34 ]. Another mechanism of Long COVID associates autoimmunity with pathobiology of B cells.…”

Rheuma nach COVID-19-Infektion oder Impfung

“…Unabhängig von Patienten mit Long COVID wird aber zunehmend von Patienten berichtet, bei denen nach einer COVID-19-Infektion Symptome einer chronischen entzündlich-rheumatischen Erkrankung beginnen [3][4][5]. Dazu zählen Symptome einer Arthritis, Myositis, autoinflammatorische Symptome, Beschwerden passend zu Kollagenosen oder chronischen entzündlich-rheumatischen Erkrankungen, die nicht assoziiert sind mit Autoantikörpern, wie zum Beispiel Psoriasis mit Psoriasisarthritis oder andere Spondylarthropathien [6,7]. [17].…”