Post-COVID-19 arthritis: a case report and literature review

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) is the novel pathogen responsible for the coronavirus disease 19 (COVID-19) outbreak. Researchers and clinicians are exploring the pathogenetic mechanisms of the viral-induced damage and growing interest is focusing on the short-term and long-term immune-mediated consequences triggered by the infection. We will focus on post-SARS-CoV2 infection arthritis which may arise as a new pathological condition associated with COVID-19. In this article, we describe a case of acute oligoarthritis occurring 13 days after a SARS-CoV2 severe pneumonia in a middle-aged Caucasian man and we go over a brief review of the current available literature. We hypothesize that molecular mimicry might be the basic immunological mechanism responsible for the onset of COVID-19-related arthritis based on the current knowledge of SARS-CoV2 and on the known pathogenetic mechanism of viral-induced arthritis.

Pathogenic implications, incidence, and outcomes of COVID-19 in autoimmune inflammatory joint diseases and autoinflammatory disorders

“…However, due to the heterogeneity of randomized controlled trials (RCTs) design and cohorts, and the presence of limitations, as for example concomitant steroidal treatment, studies have showed mixed results on the impact of these therapies on COVID-19 outcomes [7,8]. Many questions remain still open and one of the most important is whether patients with autoimmune arthropathies and autoinflammatory disorders may have different responses to the SARS-CoV-2 infection, because of impaired immunological and genetic background and/or concomitant antirheumatic treatment [9][10][11].…”

Broad clinical spectrum of SARS-CoV-2-associated inflammatory joint disease in adults: a report of 35 cases from the COVID-19 & Autoimmune Systemic Disease Italian study group

“…3 Consistent with these premises, from the earliest phases of the pandemic, inflammatory musculoskeletal manifestations following COVID-19 have been described in isolated case reports although no systematically collected cohorts are still available to unveil the clinical spectrum of post-COVID-19 arthritis. 4 To contribute to shed light on this field, in December 2020, we built a web-based survey platform and invited all members of our study group to submit cases of inflammatory joint disease and onset within 8 weeks from a confirmed SARS-CoV-2 infection (demonstrated either by reverse transcription PCR on nasopharyngeal swab or SARS-CoV-2specific IgM antibodies) encountered during routine clinical practice from 31 January 2020 and up to 31 March 2021. Exclusion criteria were a history of any inflammatory rheumatic disease or psoriasis.…”

Case Report of a Saga of Post-COVID-19 Complications

“…Arthrocentesis revealed the inflammatory nature of synovial fluid [12]. Progressive nature of the arthritis and absence of affection of joints other than the hip makes our case unique.…”