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Current Rheumatology Reviews

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Systematic Review Article

The Association between COVID-19 and Reactive Arthritis: A Systematic Review of Case Reports and Case Series

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* and Mohammad Javad Nasiri*

Volume 19, Issue 4, 2023

Published on: 10 April, 2023

Page: [420 - 438] Pages: 19

DOI: 10.2174/1573397119666230316091809

Price: $65

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.

Keywords: Arthritis, COVID-19, reactive arthritis, SARS-CoV-2, joint inflammation, musculoskeletal pain.

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