Analysis of the course of immune-mediated inflammatory rheumatic diseases after COVID-19: flare frequency and prognostic determinants
https://doi.org/10.14412/1996-7012-2025-4-25-31
Abstract
Even after the end of the COVID-19 pandemic, the SARS-CoV-2 virus continues to circulate in the population and influence the course of immune-mediated inflammatory rheumatic diseases (IMIRDs). Previous COVID-19 infection may be associated with increased IMIRD activity; however, data on the long-term post-infectious impact of COVID-19 on rheumatic disease progression remain limited.
Objective: To assess dynamics of IMIRDs course in patients with a history of COVID-19, based on individual disease activity indices measured at 3, 6, and 12 months after infection.
Material and Methods. A retrospective-prospective cohort study included 100 patients with IMIRDs (rheumatoid arthritis [RA], systemic lupus erythematosus, systemic sclerosis, and ankylosing spondylitis) who had experienced COVID-19. Disease activity was assessed using validated indices: DAS28, SLEDAI-2K, modified Valentini index, and ASDAS. Data were analyzed using nonparametric statistical methods and performance analysis (ROC-analysis).
Results and discussion. At 3 months post-COVID-19, high or very high disease activity was noted in 51% of patients; at 12 months, activity decreased to 38.8%. Persistent high disease activity was observed in 18% of patients throughout the follow-up period, most commonly in RA patients. Risk factors for experiencing ≥2 disease flares included a history of COVID-19-associated pneumonia (odds ratio [OR] 7.1; 95% confidence interval [CI] 1.6–32.2; p=0.011) and comorbid pathology (OR 6.7; 95% CI 1.3–34.9; p=0.024). The prognostic model demonstrated high diagnostic accuracy: sensitivity 89.4%, specificity 82.5%.
Conclusions. Previous COVID-19 infection is associated with a high frequency of IMIRD flares, particularly during the early post-infection months. Development of a risk stratification model may optimize patient management in the post-COVID period.
About the Authors
S. T. AbishevaKazakhstan
49A, Beibitshilik Street, Astana 010000
A. M. Lila
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522;
2/1, Barrikadnaya Street, Build. 1, Moscow 125993
K. S. Rutskaya-Moroshan
Kazakhstan
49A, Beibitshilik Street, Astana 010000
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Review
For citations:
Abisheva ST, Lila AM, Rutskaya-Moroshan KS. Analysis of the course of immune-mediated inflammatory rheumatic diseases after COVID-19: flare frequency and prognostic determinants. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2025;19(4):25-31. (In Russ.) https://doi.org/10.14412/1996-7012-2025-4-25-31