The Impact of The COVID-19 Pandemic on The Incidence of Adult and Pediatric Inflammatory Arthritis

Abstract

Background The SARS-CoV-2 pandemic has impacted both adult and pediatric populations. There is evidence that patients developed more chronic autoimmune diseases after the onset of pandemic. In scientific meetings and reported case series there has been discussion about whether those patients with genetic tendency to develop rheumatologic illnesses started to develop illness at an increased rate due to SAR-CoV-2 viral induction of the host immune defense. Objective Our study objective was to determine whether the incidence of new onset rheumatologic diseases has increased with the COVID-19 pandemic, focusing on those that involve interferon type I pathway dysfunction, such as juvenile idiopathic arthritis and adult rheumatoid arthritis at the global level. Methods We used de-identified, aggregated data from the electronic health records (EHRs) of 65 global healthcare organizations, including over 60 million people, through the TriNetX platform. Deidentified data were queried and analyzed from the COVID-19 research network of TriNetX from October 2018 to July 2021 using simple chi-square statistics of independence. Results Our results showed that among the SARS-CoV-2 positive patients compared to SARS-COV-2 negative patient there is a significant increase in the incidence rate of new onset adult “seronegative RA”, “other unspecified RA” in all adult age groups, “seropositive RA” above 50-year-old age. And “other juvenile idiopathic arthritis” subgroup in the pediatric population. Conclusion The results of this study suggest that there might be an association of SARS-CoV-2 infection in the etiopathogenesis of some subtypes of childhood and adult rheumatoid arthritis. This association could be explained by dysregulation of type I interferon activation signaling pathways that play roles in the pathogenesis of autoimmune arthritis in these subgroups and seems to be more significant in the older patient age groups above 50 years.