mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2021-5-76-79mrj-1201Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL OBSERVATIONSПолиартрит, ассоциированный с COVID-19 (клинический случай)Polyarthritis associated with COVID-19 (clinical case)https://orcid.org/0000-0002-1833-5357АроноваЕ. С.AronovaE. S.

Евгения Сергеевна Аронова

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

eugpozd@mail.ruhttps://orcid.org/0000-0001-7091-2054БеловБ. С.BelovB. S.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation2021191020211557679Copyright © Аронова Е.С., Белов Б.С., 20212021Аронова Е.С., Белов Б.С.Aronova E.S., Belov B.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/1201

В статье приводится описание клинического наблюдения дебюта полиартрита после перенесенного COVID-19. Представлены клинические данные и результаты лабораторных и инструментальных методов обследования в динамике, а также подходы к терапии. В обсуждении отражены современные взгляды на причины развития суставного синдрома после SARS-CoV-2, указано на необходимость внимательного изучения анамнеза, клинических и лабораторных данных пациентов с COVID-19.

The article describes the clinical observation of the onset of polyarthritis after COVID-19. Clinical data, laboratory tests' and instrumental methods results in dynamics, as well as approaches to therapy are presented. The discussion reflects modern views on the causes of the development of articular syndrome after SARS-CoV-2, with special attention to the need for a careful study of the history, clinical and laboratory data of patients with COVID-19.

COVID-19SARS-CoV-2постковидный синдромреактивный артритсуставной синдромаутоиммунные нарушенияаутоиммуные заболевания.COVID-19SARS-CoV-2postcovid syndromereactive arthritisarticular syndromeautoimmune disordersautoimmune diseasesИсследование выполнено в рамках темы «Коморбидные инфекции при ревматических заболеваниях и проблемы безопасности антиревматической терапии» (АААА-А19-119021190148-3).The investigation has been conducted within scientific topic №AAAA-A19-119021190148-3 «Comorbid infections in rheumatic diseases and safety problems of antirheumatic therapy».ReferencesYokogawa N, Minematsu N, Katano H, Suzuki T. Case of acute arthritis following SARS-CoV-2 infection. Ann Rheum Dis. 2020 Jun 26;annrheumdis-2020-218281. doi: 10.1136/annrheumdis-2020-218281.Online ahead of print.Yokogawa N, Minematsu N, Katano H, Suzuki T. Case of acute arthritis following SARS-CoV-2 infection. Ann Rheum Dis. 2020 Jun 26;annrheumdis-2020-218281. doi: 10.1136/annrheumdis-2020-218281.Online ahead of print.Saricaoglu EM, Hasanoglu I, Guner R. The first reactive arthritis case associated with COVID-19. J Med Virol. 2021 Jan;93(1):192-3. doi: 10.1002/jmv.26296. Epub 2020 Jul 19.Saricaoglu EM, Hasanoglu I, Guner R. The first reactive arthritis case associated with COVID-19. J Med Virol. 2021 Jan;93(1):192-3. doi: 10.1002/jmv.26296. Epub 2020 Jul 19.De Stefano L, Rossi S, Montecucco C, Bugatti S. Transient monoarthritis and psoriatic skin lesions following COVID-19. Ann Rheum Dis. 2020 Aug 4;annrheumdis-2020-218520. doi: 10.1136/annrheumdis-2020-218520. Online ahead of print.De Stefano L, Rossi S, Montecucco C, Bugatti S. Transient monoarthritis and psoriatic skin lesions following COVID-19. Ann Rheum Dis. 2020 Aug 4;annrheumdis-2020-218520. doi: 10.1136/annrheumdis-2020-218520. Online ahead of print.Liew IY, Mak TM, Cui L, et al. A case of reactive arthritis secondary to coronavirus disease 2019 infection. J Clin Rheumatol. 2020 Sep;26(6):233. doi: 10.1097/RHU.0000000000001560.Liew IY, Mak TM, Cui L, et al. A case of reactive arthritis secondary to coronavirus disease 2019 infection. J Clin Rheumatol. 2020 Sep;26(6):233. doi: 10.1097/RHU.0000000000001560.Ono K, Kishimoto M, Shimasaki T, et al. Reactive arthritis after COVID-19 infection. RMD Open. 2020 Aug;6(2):e001350. doi: 10.1136/rmdopen-2020-001350.Ono K, Kishimoto M, Shimasaki T, et al. Reactive arthritis after COVID-19 infection. RMD Open. 2020 Aug;6(2):e001350. doi: 10.1136/rmdopen-2020-001350.Alivernini S, Cingolani A, Gessi M, et al. Comparative analysis of synovial inflammation after SARS-CoV-2 infection. Ann Rheum Dis. 2020 Jul 6;annrheumdis-2020-218315. doi: 10.1136/annrheumdis-2020-218315.Online ahead of print.Alivernini S, Cingolani A, Gessi M, et al. Comparative analysis of synovial inflammation after SARS-CoV-2 infection. Ann Rheum Dis. 2020 Jul 6;annrheumdis-2020-218315. doi: 10.1136/annrheumdis-2020-218315.Online ahead of print.Skendros P, Mitsios A, Chrysanthopoulou A, et al. Complement and tissue factor-enriched neutrophil extracellular traps are key drivers in COVID-19 immunothrombosis. J Clin Invest. 2020 Nov 2;130(11):6151-7. doi: 10.1172/JCI141374.Skendros P, Mitsios A, Chrysanthopoulou A, et al. Complement and tissue factor-enriched neutrophil extracellular traps are key drivers in COVID-19 immunothrombosis. J Clin Invest. 2020 Nov 2;130(11):6151-7. doi: 10.1172/JCI141374.Ahmed S, Zimba O, Gasparyan AY. COVID-19 and the clinical course of rheumatic manifestations. Clin Rheumatol. 2021 Jul;40(7):2611-9. doi: 10.1007/s10067-021-05691-x. Epub 2021 Mar 17.Ahmed S, Zimba O, Gasparyan AY. COVID-19 and the clinical course of rheumatic manifestations. Clin Rheumatol. 2021 Jul;40(7):2611-9. doi: 10.1007/s10067-021-05691-x. Epub 2021 Mar 17.Sawadogo SA, Dighero-Kemp B, Ouedraogo DD, et al. How NETosis could drive «post-COVID-19 syndrome» among survivors. Immunol Lett. 2020 Dec;228:35-7. doi: 10.1016/j.imlet.2020.09.005. Epub 2020 Sep 29.Sawadogo SA, Dighero-Kemp B, Ouedraogo DD, et al. How NETosis could drive «post-COVID-19 syndrome» among survivors. Immunol Lett. 2020 Dec;228:35-7. doi: 10.1016/j.imlet.2020.09.005. Epub 2020 Sep 29.Garcia LF, Response I. Immune response, inflammation, and the clinical spectrum of COVID-19. Front Immunol. 2020 Jun 16;11:1441. doi: 10.3389/fimmu.2020.01441. eCollection 2020.Garcia LF, Response I. Immune response, inflammation, and the clinical spectrum of COVID-19. Front Immunol. 2020 Jun 16;11:1441. doi: 10.3389/fimmu.2020.01441. eCollection 2020.McGonagle D, Sharif K, O’Regan A, et al. The role of cytokines including interleukin-6 in COVID-19 induced pneumonia and macrophage activation syndrome-like disease. Autoimmun Rev. 2020 Jun;19(6):102537. doi: 10.1016/j.autrev.2020.102537. Epub 2020 Apr 3.McGonagle D, Sharif K, O’Regan A, et al. The role of cytokines including interleukin-6 in COVID-19 induced pneumonia and macrophage activation syndrome-like disease. Autoimmun Rev. 2020 Jun;19(6):102537. doi: 10.1016/j.autrev.2020.102537. Epub 2020 Apr 3.Beringer A, Miossec P. Systemic effects of IL-17 in inflammatory arthritis. Nat Rev Rheumatol. 2019 Aug;15(8):491-501. doi: 10.1038/s41584-019-0243-5. Epub 2019 Jun 21.Beringer A, Miossec P. Systemic effects of IL-17 in inflammatory arthritis. Nat Rev Rheumatol. 2019 Aug;15(8):491-501. doi: 10.1038/s41584-019-0243-5. Epub 2019 Jun 21.Pacha O, Sallman MA, Evans SE. COVID-19: a case for inhibiting IL-17? Nat Rev Immunol. 2020 Jun;20(6):345-346. doi: 10.1038/s41577-020-0328-z.Pacha O, Sallman MA, Evans SE. COVID-19: a case for inhibiting IL-17? Nat Rev Immunol. 2020 Jun;20(6):345-346. doi: 10.1038/s41577-020-0328-z.Odak I, Barros-Martins J, Bosnjak B, et al. Reappearance of effector T cells is associated with recovery from COVID-19. EBioMedicine. 2020 Jul;57:102885. doi: 10.1016/j.ebiom.2020.102885. Epub 2020 Jul 7.Odak I, Barros-Martins J, Bosnjak B, et al. Reappearance of effector T cells is associated with recovery from COVID-19. EBioMedicine. 2020 Jul;57:102885. doi: 10.1016/j.ebiom.2020.102885. Epub 2020 Jul 7.Canas CA. The triggering of post- COVID-19 autoimmunity phenomena could be associated with both transient immunosuppression and an inappropriate form of immune reconstitution in susceptible individuals. Med Hypotheses. 2020 Dec;145:110345. doi: 10.1016/j.mehy.2020.110345.Epub 2020 Oct 14.Canas CA. The triggering of post- COVID-19 autoimmunity phenomena could be associated with both transient immunosuppression and an inappropriate form of immune reconstitution in susceptible individuals. Med Hypotheses. 2020 Dec;145:110345. doi: 10.1016/j.mehy.2020.110345.Epub 2020 Oct 14.Arango MT, Perricone C, Kivity S, et al. HLA-DRB1 the notorious gene in the mosaic of autoimmunity. Immunol Res. 2017 Feb; 65(1):82-98. doi: 10.1007/s12026-016-8817-7.Arango MT, Perricone C, Kivity S, et al. HLA-DRB1 the notorious gene in the mosaic of autoimmunity. Immunol Res. 2017 Feb; 65(1):82-98. doi: 10.1007/s12026-016-8817-7.Blank M, Barzilai O, Shoenfeld Y. Molecular mimicry and autoimmunity. Clin Rev Allergy Immunol. 2007 Feb;32(1):111-8. doi: 10.1007/BF02686087.Blank M, Barzilai O, Shoenfeld Y. Molecular mimicry and autoimmunity. Clin Rev Allergy Immunol. 2007 Feb;32(1):111-8. doi: 10.1007/BF02686087.Kanduc D, Shoenfeld Y. Human papillomavirus epitope mimicry and autoimmunity: the molecular truth of peptide sharing. Pathobiology. 2019;86(5-6):285-95. doi: 10.1159/000502889. Epub 2019 Oct 8.Kanduc D, Shoenfeld Y. Human papillomavirus epitope mimicry and autoimmunity: the molecular truth of peptide sharing. Pathobiology. 2019;86(5-6):285-95. doi: 10.1159/000502889. Epub 2019 Oct 8.Lorente L, Martin MM, Franco A, et al. HLA genetic polymorphisms and prognosis of patients with COVID-19. Med Intensiva (Engl Ed). 2021 Mar;45(2):96-103. doi: 10.1016/j.medin.2020.08.004. Epub 2020 Sep 6.Lorente L, Martin MM, Franco A, et al. HLA genetic polymorphisms and prognosis of patients with COVID-19. Med Intensiva (Engl Ed). 2021 Mar;45(2):96-103. doi: 10.1016/j.medin.2020.08.004. Epub 2020 Sep 6.Tomita Y, Ikeda T, Sato R, Sakagami T. Association between HLA gene polymorphisms and mortality of COVID-19: an in silico analysis. Immun Inflamm Dis. 2020 Dec; 8(4):684-94. doi: 10.1002/iid3.358.Epub 2020 Oct 13.Tomita Y, Ikeda T, Sato R, Sakagami T. Association between HLA gene polymorphisms and mortality of COVID-19: an in silico analysis. Immun Inflamm Dis. 2020 Dec; 8(4):684-94. doi: 10.1002/iid3.358.Epub 2020 Oct 13.Novelli A, Andreani M, Biancolella M, et al. HLA allele frequencies and susceptibility to COVID-19 in a group of 99 Italian patients. HLA. 2020 Nov;96(5):610-4. doi: 10.1111/tan.14047. Epub 2020 Sep 3.Novelli A, Andreani M, Biancolella M, et al. HLA allele frequencies and susceptibility to COVID-19 in a group of 99 Italian patients. HLA. 2020 Nov;96(5):610-4. doi: 10.1111/tan.14047. Epub 2020 Sep 3.Sedaghat Z, Karimi N. Guillain Barre syndrome associated with COVID-19 infection: a case report. J Clin Neurosci. 2020 Jun; 76:233-5. doi: 10.1016/j.jocn.2020.04.062.Epub 2020 Apr 15.Sedaghat Z, Karimi N. Guillain Barre syndrome associated with COVID-19 infection: a case report. J Clin Neurosci. 2020 Jun; 76:233-5. doi: 10.1016/j.jocn.2020.04.062.Epub 2020 Apr 15.Toscano G, Palmerini F, Ravaglia S, et al. Guillain-Barre syndrome associated with SARS-CoV-2. N Engl J Med. 2020 Jun 25; 382(26):2574-6. doi: 10.1056/NEJMc 2009191. Epub 2020 Apr 17.Toscano G, Palmerini F, Ravaglia S, et al. Guillain-Barre syndrome associated with SARS-CoV-2. N Engl J Med. 2020 Jun 25; 382(26):2574-6. doi: 10.1056/NEJMc 2009191. Epub 2020 Apr 17.Manganotti P, Pesavento V, Buoite Stella A, et al. Miller fisher syndrome diagnosis and treatment in a patient with SARS-CoV-2. J Neurovirol. 2020 Aug;26(4):605-6. doi: 10.1007/s13365-020-00858-9. Epub 2020 Jun 11.Manganotti P, Pesavento V, Buoite Stella A, et al. Miller fisher syndrome diagnosis and treatment in a patient with SARS-CoV-2. J Neurovirol. 2020 Aug;26(4):605-6. doi: 10.1007/s13365-020-00858-9. Epub 2020 Jun 11.Zhang Y, Cao W, Jiang W, et al. Profile of natural anticoagulant, coagulant factor and anti-phospholipid antibody in critically ill COVID-19 patients. J Thromb Thrombolysis. 2020 Oct;50(3):580-6. doi: 10.1007/s11239-020-02182-9.Zhang Y, Cao W, Jiang W, et al. Profile of natural anticoagulant, coagulant factor and anti-phospholipid antibody in critically ill COVID-19 patients. J Thromb Thrombolysis. 2020 Oct;50(3):580-6. doi: 10.1007/s11239-020-02182-9.Tsao HS, Chason HM, Fearon DM. Immune Thrombocytopenia (ITP) in a pediatric patient positive for SARS-CoV-2. Pediatrics. 2020 Aug;146(2):e20201419. doi: 10.1542/peds.2020-1419. Epub 2020 May 21.Tsao HS, Chason HM, Fearon DM. Immune Thrombocytopenia (ITP) in a pediatric patient positive for SARS-CoV-2. Pediatrics. 2020 Aug;146(2):e20201419. doi: 10.1542/peds.2020-1419. Epub 2020 May 21.Zulfiqar AA, Lorenzo-Villalba N, Hassler P, Andres E. Immune thrombocytopenic Purpura in a patient with Covid-19. N Engl J Med. 2020 Apr 30;382(18):e43. doi: 10.1056/NEJMc2010472. Epub 2020 Apr 15.Zulfiqar AA, Lorenzo-Villalba N, Hassler P, Andres E. Immune thrombocytopenic Purpura in a patient with Covid-19. N Engl J Med. 2020 Apr 30;382(18):e43. doi: 10.1056/NEJMc2010472. Epub 2020 Apr 15.Bonometti R, Sacchi MC, Stobbione P, et al. The first case of systemic lupus erythematosus (SLE) triggered by COVID-19 infection. Eur Rev Med Pharmacol Sci. 2020 Sep; 24(18):9695-7. doi: 10.26355/eurrev_202009_23060.Bonometti R, Sacchi MC, Stobbione P, et al. The first case of systemic lupus erythematosus (SLE) triggered by COVID-19 infection. Eur Rev Med Pharmacol Sci. 2020 Sep; 24(18):9695-7. doi: 10.26355/eurrev_202009_23060.Jones VG, Mills M, Suarez D, et al. COVID-19 and Kawasaki disease: novel virus and novel case. Hosp Pediatr. 2020 Jun;10(6): 537-40. doi: 10.1542/hpeds.2020-0123.Epub 2020 Apr 7.Jones VG, Mills M, Suarez D, et al. COVID-19 and Kawasaki disease: novel virus and novel case. Hosp Pediatr. 2020 Jun;10(6): 537-40. doi: 10.1542/hpeds.2020-0123.Epub 2020 Apr 7.Verdoni L, Mazza A, Gervasoni A, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020 Jun 6;395(10239):1771-8. doi: 10.1016/S0140-6736(20)31103-X. Epub 2020 May 13.Verdoni L, Mazza A, Gervasoni A, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020 Jun 6;395(10239):1771-8. doi: 10.1016/S0140-6736(20)31103-X. Epub 2020 May 13.Megremis S, Walker TDJ, He X, et al. Antibodies against immunogenic epitopes with high sequence identity to SARS-CoV-2 in patients with autoimmune dermatomyositis. Ann Rheum Dis. 2020 Oct;79(10):1383-6. doi: 10.1136/annrheumdis-2020-217522. Epub 2020 May 22.Megremis S, Walker TDJ, He X, et al. Antibodies against immunogenic epitopes with high sequence identity to SARS-CoV-2 in patients with autoimmune dermatomyositis. Ann Rheum Dis. 2020 Oct;79(10):1383-6. doi: 10.1136/annrheumdis-2020-217522. Epub 2020 May 22.Halpert G, Shoenfeld Y. SARS-CoV-2, the autoimmune virus. Autoimmun Rev. 2020 Dec;19(12):102695. doi: 10.1016/j.autrev.2020. 102695. Epub 2020 Oct 28.Halpert G, Shoenfeld Y. SARS-CoV-2, the autoimmune virus. Autoimmun Rev. 2020 Dec;19(12):102695. doi: 10.1016/j.autrev.2020. 102695. Epub 2020 Oct 28.Cleary SJ, Pitchford SC, Amison RT, et al. Animal models of mechanisms of SARSCoV-2 infection and COVID-19 pathology. Br J Pharmacol. 2020 Nov;177(21):4851-65. doi: 10.1111/bph.15143. Epub 2020 Jul 19.Cleary SJ, Pitchford SC, Amison RT, et al. Animal models of mechanisms of SARSCoV-2 infection and COVID-19 pathology. Br J Pharmacol. 2020 Nov;177(21):4851-65. doi: 10.1111/bph.15143. Epub 2020 Jul 19.

The authors declare that there are no conflicts of interest present.