Background Rheumatological disease flares may be seen after many infections. However, our knowledge for the post-COVID axial spondyloarthritis (SpA) flares and its related factors is limited.

Objectives We aimed to evaluate disease activity and factors that may be associated with disease activity in axial SpA patients in post-COVID period.

Methods We retrospectively assessed the axial SpA patients who have had COVID-19 disease confirmed by a positive SARS-CoV-2 polymerized chain reaction (PCR) test result. Demographics, comorbid diseases, active medical treatments for SpA and information regarding COVID-19 clinical courses were collected from medical records. PCR positive patients were reached via telephone and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scored for pre- and post-COVID SpA symptoms. An increase of ≥2 points in the BASDAI score was defined as flare, and SpA groups with and without flare were compared. Factors predicting SpA flare were also analyzed by the logistic regression analysis.

Results A total of 48 axial SpA patients were included in our study, 65% of them male and the mean±SD age was 42.3±8.6 years. Post-COVID SpA flare was seen in 38% patients. Demographic, clinical, medical features of the SpA patients and COVID-19 disease severity were similar between Flare and No flare groups. In comparison of the COVID-19 symptoms, although most of the COVID-19 related symptoms were similar between two groups, the frequency of the back pain and diarrhea were higher in the Flare group than No flare group. But in multivariate analysis, only history of the inflammatory bowel disease had an increased risk for post-COVID SpA flare (Table 1).

Conclusion The presence of inflammatory bowel disease statistically significant related post-COVID SpA flares. In addition, diarrhea and back pain symptoms in COVID-19 disease may be stimulating factors for SpA flares but we found no effect of rheumatological therapies.

Disclosure of Interests None declared