Title:The Association between COVID-19 and Reactive Arthritis: A Systematic
Review of Case Reports and Case Series
Volume: 19
Issue: 4
Author(s): Kosar Namakin, Sara Sadeghzadeh, Atena Tamimi, Ayfar Abdolzadeh, Zahra Khanjani, Navid Ebrahimi, Golara Abdolmohammadi, Ahmadreza Golshan, Shakiba Fardoost, Soroush Masrouri, Bahareh Hajikhani, Alireza Salimi Chirani, Moein Zangiabadian*Mohammad Javad Nasiri*
Affiliation:
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Keywords:
Arthritis, COVID-19, reactive arthritis, SARS-CoV-2, joint inflammation, musculoskeletal pain.
Abstract:
Introduction: Reactive arthritis (ReA) is a joint inflammation that follows an infection at a distant site, often in the gastrointestinal or urogenital tract. Since the emergence of COVID-19 in January 2020, several case reports have suggested a relation between reactive arthritis and severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), due to the novelty of the disease, most findings were reported in the form of case reports or case series, and a comprehensive overview is still lacking.
Methods: We searched PubMed/Medline and Embase to identify studies addressing the association between ReA and COVID-19. The following terms were used: (“Reactive Arthritis” OR “Post-Infectious Arthritis” OR “Post Infectious Arthritis”) AND (“COVID-19” OR “SARS-CoV-2” OR “2019-nCoV”).
Results: A total number of 35 reports published up to February 16th, 2022, were included in this study. A wide range of ages was affected (mean 41.0, min 4 max 78), with a higher prevalence of males (61.0%) from 16 countries. The number and location of the affected joints were different in included patients, with a higher prevalence of polyarthritis in 41.5% of all cases. Cutaneous manifestations and visual impairments were found as the most common associated symptoms. Most patients (95.1%) recovered, with a mean recovery time of 24 days. Moreover, arthritis induced by COVID-19 seems to relieve faster than ReA, followed by other infections.
Conclusion: ReA can be a possible sequel of COVID-19 infection. Since musculoskeletal pain is a frequent symptom of COVID-19, ReA with rapid onset can easily be misdiagnosed. Therefore, clinicians should consider ReA a vital differential diagnosis in patients with post-COVID-19 joint swelling. Additional studies are required for further analysis and to corroborate these findings.
