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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
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Giant Cell Arteritis and COVID-19: Similarities and Discriminators. A Systematic Literature Review

Puja Mehta1, Sebastian E Sattui2, Kornelis S M van der Geest3

  • 1P. Mehta, Rheumatology Fellow, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory, Division of Medicine, University College London, Department of Rheumatology, University College London Hospital (UCLH) NHS Trust, London, UK.

The Journal of Rheumatology
|October 16, 2020
PubMed

Insights

Giant cell arteritis (GCA) and COVID-19 share symptoms like headache and fever, but distinct features such as jaw claudication in GCA and lymphopenia in COVID-19 aid diagnosis. Awareness can prevent delays in GCA treatment.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Giant cell arteritis (GCA) and coronavirus disease 2019 (COVID-19) can present with overlapping symptoms, potentially leading to diagnostic challenges.
  • Accurate and timely diagnosis is crucial for effective treatment and management of both conditions.

Purpose of the Study:

  • To delineate shared and distinct clinical and laboratory features of GCA and COVID-19.
  • To minimize diagnostic errors and reduce treatment delays for patients with suspected GCA.

Main Methods:

  • Two systematic literature reviews were conducted to identify the frequency of clinical features in GCA and COVID-19.
  • Frequencies of reported features were summarized using medians and ranges.

Main Results:

  • Shared symptoms include headache, fever, elevated C-reactive protein (CRP), and cough. GCA frequently presents with jaw claudication (43%) and visual loss (26%), not typical in COVID-19.
  • Distinctive findings include elevated platelet counts in GCA (47% vs. 4% in COVID-19) and lymphopenia in COVID-19 (53% vs. 2% in GCA).
  • Fatigue is common in both diseases, while gastrointestinal upset and altered smell/taste are less consistently reported.

Conclusions:

  • Overlapping symptoms necessitate careful evaluation to differentiate GCA from COVID-19.
  • Features like jaw claudication, visual loss, platelet count, and lymphocyte count are key discriminators.
  • A checklist has been developed to support evidence-based assessment of patients with suspected GCA, aiming to improve diagnostic accuracy.
Abstract

Keywords:
coronavirusdiagnosisgiant cell arteritis

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