COVID-associated arthritis after severe and non-severe COVID-19: A systematic review

• Published in: Immunity, Inflammation and Disease Inflammation and Disease, 2023-10, Vol.11 (10), p.e1035-n/a
• Main Authors: Zarpoosh, Mahsa, Amirian, Parsa
• Format: Article
• Language: English
• Subjects: Antibodies; Antigens; Arthritis; Arthritis - drug therapy; Arthritis - epidemiology; Arthritis - etiology; Biopsy; Case reports; COVID-19; COVID-19 - complications; COVID‐19 severity; COVID‐associated arthritis; Disease transmission; Gastrointestinal surgery; Humans; Immunosuppressive Agents - therapeutic use; Infections; inflammatory arthritis; Knee; reactive arthritis; Review; Sacroiliitis; Severe acute respiratory syndrome coronavirus 2; Sexually transmitted diseases; STD; Steroids; Systematic review; Ultrasonic imaging; Viral infections
• ISSN: 2050-4527; 2050-4527
• DOI: 10.1002/iid3.1035

Since the coronavirus outbreak became a global health emergency in 2020, various immune-based effects, such as inflammatory arthritis (IA), have been recorded. This study aimed to determine the role of COVID-19 severity on post-COVID arthritis. We systematically reviewed 95 patients who developed arthritis after severe and non-severe COVID-19 infection by searching the databases, including PubMed, SCOPUS, and EMBASE. We used the term "COVID-associated arthritis" because there was no definite diagnostic method for classifying arthritides after COVID-19 infection, and the diagnosed arthritis types were based on the authors' viewpoints. After evaluating the data between the two severe and non-severe COVID-19-infected groups of patients, the results showed that the COVID-19 severity may affect the pattern of joint involvement in IA. In both groups, combination therapy, including oral nonsteroidal anti-inflammatory drugs with different types of corticosteroids, was the most common treatment. In addition, the mean age and comorbidities rate was higher in the severe COVID-19 group. Even though the patients in the severe COVID-19 group developed more serious COVID-19 symptoms, they experienced milder arthritis with better outcomes and more delayed onsets that required less aggressive therapy. We conclude that there may be an inverse relationship between COVID-19 severity and arthritis severity, possibly due to weaker immunity conditions following immunosuppressant treatments in patients with severe COVID-19.