1
|
Mudge HR, Honey JR, Tachoukaft S, Hider SL, Mason KJ, Welsh VK, Burton C. Summarizing Evidence of Associations of COVID-19 With a Future Diagnosis of Inflammatory Rheumatic and Musculoskeletal Diseases: A Rapid Review. Arthritis Care Res (Hoboken) 2024; 76:40-48. [PMID: 37691274 DOI: 10.1002/acr.25227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/11/2023] [Accepted: 08/31/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE Musculoskeletal symptoms are commonly reported following acute COVID-19. It is unclear whether those with musculoskeletal symptoms subsequently develop inflammatory rheumatic musculoskeletal disease (iRMD). This review seeks to identify evidence for an association between acute COVID-19 and subsequent iRMD diagnosis. METHODS A rapid review of the literature using a systematic search of Medline, EMBASE and two COVID-19 databases was undertaken until August 2022. Case studies, case series, cross-sectional, case-control, and cohort studies reporting patients with an incident iRMD following COVID-19 were included. Title and abstract screening were conducted by one reviewer and full text screening by two reviewers. Data extraction and quality appraisal were by one reviewer, with a second verifying. Study-type specific critical appraisal tools were used. RESULTS Results were narratively synthesized. A total of 80 studies were included (69 case reports, 10 case series and 1 cross-sectional study). Commonly reported iRMDs were "reactive arthropathies" (n = 47), "inflammatory arthropathies unspecified" (n = 18), rheumatoid arthritis (n = 12) and systemic lupus erythematosus (n = 11). The cross-sectional study reported 37% of those with COVID-19 developed "post COVID arthritis." Time from diagnosis of COVID-19 to iRMD presentation ranged from 0 to 120 days. Several mechanisms were proposed to explain the association between COVID-19 and iRMD development: autoimmune processes, aberrant inflammatory responses, colonization of joint spaces, direct damage from the severe acute respiratory syndrome coronavirus 2 virus and genetic predisposition. CONCLUSION The level of evidence of the studies included in this review was low and the quality generally poor. Prospective observational studies are required to confirm associations and likely impact of post COVID-19 iRMDs at a population level.
Collapse
Affiliation(s)
| | - Jonathan R Honey
- Salisbury NHS Foundation Trust, Wessex Foundation School, Salisbury, UK
| | | | | | | | | | | |
Collapse
|
2
|
Marques CDL, Ribeiro SLE, Albuquerque CP, de Sousa Studart SA, Ranzolin A, de Andrade NPB, Dantas AT, Mota GD, Resende GG, Marinho AO, Angelieri D, Andrade D, Ribeiro FM, Omura F, Silva NA, Rocha Junior L, Brito DE, Fernandino DC, Yazbek MA, Souza MPG, Ximenes AC, Martins ASS, Castro GRW, Oliveira LC, Freitas ABSB, Kakehasi AM, Gomides APM, Reis Neto ET, Pileggi GS, Ferreira GA, Mota LMH, Xavier RM, de Medeiros Pinheiro M. COVID-19 was not associated or trigger disease activity in spondylarthritis patients: ReumaCoV-Brasil cross-sectional data. Adv Rheumatol 2022; 62:45. [PMID: 36419163 PMCID: PMC9685130 DOI: 10.1186/s42358-022-00268-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To evaluate the disease activity before and after COVID-19 and risk factors associated with outcomes, including hospitalization, intensive care unit (ICU) admission, mechanical ventilation (MV) and death in patients with spondylarthritis (SpA). METHODS ReumaCoV Brazil is a multicenter prospective cohort of immune-mediated rheumatic diseases (IMRD) patients with COVID-19 (case group), compared to a control group of IMRD patients without COVID-19. SpA patients enrolled were grouped as axial SpA (axSpA), psoriatic arthritis (PsA) and enteropathic arthritis, according to usual classification criteria. RESULTS 353 SpA patients were included, of whom 229 (64.9%) were axSpA, 118 (33.4%) PsA and 6 enteropathic arthritis (1.7%). No significant difference was observed in disease activity before the study inclusion comparing cases and controls, as well no worsening of disease activity after COVID-19. The risk factors associated with hospitalization were age over 60 years (OR = 3.71; 95% CI 1.62-8.47, p = 0.001); one or more comorbidities (OR = 2.28; 95% CI 1.02-5.08, p = 0.001) and leflunomide treatment (OR = 4.46; 95% CI 1.33-24.9, p = 0.008). Not having comorbidities (OR = 0.11; 95% CI 0.02-0.50, p = 0.001) played a protective role for hospitalization. In multivariate analysis, leflunomide treatment (OR = 8.69; CI = 95% 1.41-53.64; p = 0.023) was associated with hospitalization; teleconsultation (OR = 0.14; CI = 95% 0.03-0.71; p = 0.01) and no comorbidities (OR = 0.14; CI = 95% 0.02-0.76; p = 0.02) remained at final model as protective factor. CONCLUSIONS Our results showed no association between pre-COVID disease activity or that SARS-CoV-2 infection could trigger disease activity in patients with SpA. Teleconsultation and no comorbidities were associated with a lower hospitalization risk. Leflunomide remained significantly associated with higher risk of hospitalization after multiple adjustments.
Collapse
Affiliation(s)
| | | | | | | | | | - Nicole Pamplona Bueno de Andrade
- grid.8532.c0000 0001 2200 7498Hospital de Clínicas de Porto Alegre – Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andrea T. Dantas
- grid.411227.30000 0001 0670 7996Hospital das Clínicas – Universidade Federal de Pernambuco, Recife, Brazil
| | - Guilherme D. Mota
- grid.411249.b0000 0001 0514 7202Universidade Federal de São Paulo, Rua Borges Lagoa, 913/ 51-53, Vila Clementino, São Paulo, SP CEP: 04038-034 Brazil
| | - Gustavo G. Resende
- grid.8430.f0000 0001 2181 4888Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Danielle Angelieri
- grid.414644.70000 0004 0411 4654Hospital dos Servidores de São Paulo – IAMSPE, São Paulo, Brazil
| | - Danieli Andrade
- grid.11899.380000 0004 1937 0722Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil
| | - Francinne M. Ribeiro
- grid.412211.50000 0004 4687 5267Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Abraão, Brazil
| | - Felipe Omura
- Clínica Omura Medicina Diagnóstica, São Paulo, Brazil
| | - Nilzio A. Silva
- grid.411195.90000 0001 2192 5801Faculdade de Medicina da Universidade Federal de Goiás, Goiânia, Brazil
| | - Laurindo Rocha Junior
- grid.419095.00000 0004 0417 6556Instituto de Medicina Integral Professor Fernando Figueira -IMIP, Recife, Brazil
| | - Danielle E. Brito
- grid.411216.10000 0004 0397 5145Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Diana C. Fernandino
- grid.411198.40000 0001 2170 9332Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Michel A. Yazbek
- grid.411087.b0000 0001 0723 2494Hospital de Clínicas da Universidade Estadual de Campinas- UNICAMP, Campinas, Brazil
| | - Mariana P. G. Souza
- grid.415169.e0000 0001 2198 9354Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
| | | | - Ana Silvia S. Martins
- grid.411284.a0000 0004 4647 6936Hospital de Clínicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Glaucio Ricardo W. Castro
- grid.413214.10000 0004 0504 2293Hospital Governador Celso Ramos – Santa Catarina, Florianópolis, Brazil
| | | | | | - Adriana M. Kakehasi
- grid.8430.f0000 0001 2181 4888Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Edgard Torres Reis Neto
- grid.411249.b0000 0001 0514 7202Universidade Federal de São Paulo, Rua Borges Lagoa, 913/ 51-53, Vila Clementino, São Paulo, SP CEP: 04038-034 Brazil
| | - Gecilmara S. Pileggi
- grid.411249.b0000 0001 0514 7202Universidade Federal de São Paulo, Rua Borges Lagoa, 913/ 51-53, Vila Clementino, São Paulo, SP CEP: 04038-034 Brazil
| | - Gilda A. Ferreira
- grid.8430.f0000 0001 2181 4888Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Licia Maria H. Mota
- grid.7632.00000 0001 2238 5157Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília (PPGCM-FM-UnB), Brazil, Brasília, DF Brazil ,grid.411215.2Hospital Universitário de Brasília (HUB-UnB-EBSERH), Brasília, DF Brazil
| | - Ricardo M. Xavier
- grid.8532.c0000 0001 2200 7498Hospital de Clínicas de Porto Alegre – Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marcelo de Medeiros Pinheiro
- grid.411249.b0000 0001 0514 7202Universidade Federal de São Paulo, Rua Borges Lagoa, 913/ 51-53, Vila Clementino, São Paulo, SP CEP: 04038-034 Brazil
| | | |
Collapse
|