Rheumatoid arthritis occurring after coronavirus disease 2019 (COVID-19) infection: Case based review

Area of Science:

• Rheumatology
• Infectious Diseases
• Immunology

Background:

• Rheumatoid arthritis (RA) is a complex autoimmune disease influenced by genetic and environmental factors.
• Infections are recognized triggers for autoimmune conditions like RA.
• The novel coronavirus disease 2019 (COVID-19) has been implicated in various post-infectious sequelae.

Purpose of the Study:

• To report a rare case of rheumatoid arthritis (RA) developing after COVID-19 infection.
• To investigate the clinical, immunological, and genetic profile of RA post-COVID-19.
• To raise awareness among physicians about this potential complication.

Main Methods:

• A case presentation of a 72-year-old woman with polyarthritis following asymptomatic COVID-19.
• Clinical examination, inflammatory biomarker assessment (CRP, ESR, IL-6), and immunological testing (RF, anti-CCP, ANA, anti-SARS-CoV-2 IgG).
• Genetic typing (HLA-DRB1, HLA-DQB1), radiographic, and ultrasonographic evaluation of joints.

Main Results:

• The patient presented with symmetric polyarthritis, elevated inflammatory markers, and positive autoimmune antibodies (RF, anti-CCP, ANA).
• Diagnosis of RA was confirmed by synovitis and erosion on ultrasonography, despite negative initial radiographs.
• Treatment with methylprednisolone, corticosteroids, and methotrexate resulted in significant clinical and biological improvement.

Conclusions:

• The occurrence of RA after COVID-19, though rare, warrants physician consideration.
• This case underscores the potential autoimmune implications of SARS-CoV-2 infection.
• Further research is needed to elucidate the mechanisms linking COVID-19 to RA pathogenesis.