COVID-19 and post-covid syndrome in patients with rheumatoid arthritis

Objective: to study the course of COVID -19 and post-covid syndrome (PCS) in patients with rheumatoid arthritis (RA).

Material and methods. The study included 32 adult patients with a confirmed diagnosis of RA, who met ACR/EULAR criteria. All patients had COVID-19. Material for analysis was obtained by means of a questionnaire developed at the V.A. Nasonova Research Institute of Rheumatology, which patients completed during their interview with the researcher.

Results and discussion. The study group consisted mainly of women (n=29, 90%). The mean age of the patients was 50.75±16.48 years. Among the clinical manifestations of COVID-19, weakness/fatigue (90.6%; p<0.0001), fever (71.9%; p=0.0005) and anosmia (62.5%; p=0.045) were significantly more common. Almost half of the patients had dysgeusia (59.4%), increased arthralgia (53.1%), dyspnea on exertion (50%), and cough (46.9%). A significant positive association was found between increased arthralgia during COVID-19 and RA activity (r=0.72; p<0.05). Hospitalisation was required in 37.5% of patients with COVID-19. In 12.5% of cases, COVID-19 progressed with complications. Patients with higher RA activity were more likely to have an increase in arthralgia as a symptom of infection. PCS was registered in 47.8% of patients who underwent COVID-19. Retrospective evaluation of patients with PCS revealed a higher rate of hospitalisation in infectious disease departments and a more severe course of COVID-19. Subsequently, repeated cases of COVID-19 were more common in this group.

Conclusion. Risk assessment of PCS development is necessary to appropriately distribute the burden on the health care system and to develop a strategy for prevention, timely diagnosis, and treatment of this syndrome in patients with rheumatic diseases. To achieve this goal, new studies in a larger cohort of patients with RA and rheumatic diseases in general are needed.

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