Effects of COVID-19 on axial spondyloarthritis disease flare

Abstract

The coronavirus disease-2019 outbreak has become a major global health problem since December 2019. COVID-19 has heterogeneous clinical features ranging from an asymptomatic course to multi-organ failure. It is also a major cause of morbidity and mortality in some patients. In this context, patients with chronic diseases are more susceptible to these effects. The cascade of inflammatory mediators in COVID-19 may lead to many systemic symptoms (1,2). Although direct involvement of the skeletal muscles by viral agents has not been shown, approximately 15% of the cases could have arthralgia and myalgia at several sites (3).Spondyloarthritis (SpA) refers to a group of chronic inflammatory arthritis, which can be further classified according to the distribution of joint involvement as predominantly axial (SpA) or peripheral SpA. Axial forms of SpA, which consist of ankylosing spondylitis and non-radiographic axial SpA are the most frequent types and usually present with chronic lower back pain, peripheral arthritis, enthesitis, dactylitis, or in association with extra-articular manifestations include psoriasis, uveitis, and inflammatory bowel disease (4,5). Non-steroidal antiinflammatory drugs (NSAID) are frequently used in axial SpA patients along with other immunosuppressive and biological agents (6). Bath Ankylosing Spondylitis Disease Activity Index