Complete persistent remission of rheumatoid arthritis after COVID-19 infection - A rare case and literature review

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Submitted: January 7, 2022
Accepted: June 6, 2022
Published: June 8, 2022
Abstract Views: 1303
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A 55-year-old man was admitted to a hospital in Northeast India with fever, cough and breathlessness and was diagnosed with severe COVID-19 pneumonia. He was a known case of seropositive, erosive rheumatoid arthritis (RA) and was taking disease-modifying anti-rheumatic drugs (DMARDs). The patient was treated with remdesivir, heparin and a short course of corticosteroids for COVID-19 pneumonia. With the improvement of COVID-19 pneumonia, the patient also noticed a marked improvement in his joint symptoms despite not taking any DMARDs for RA. The temporal relationship between the time of disappearance of all signs and symptoms of RA within a few days after COVID-19 pneumonia and maintenance of RA remission for over one year of follow up to date suggests that COVID-19 likely caused the remission of RA. This case highlights the need for larger studies to understand the COVID-19 effects on RA remission and their potential link if any. However, the evidence of worse outcome with COVID-19 in immunosuppression which is common in RA cannot be overlooked.

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Citations

Schett G, Manger B, Simon D, Caporali R. COVID-19 revisiting inflammatory pathways of arthritis. Nat Revi Rheumatol 2020;16:465-70. DOI: https://doi.org/10.1038/s41584-020-0451-z
Rocha APD, Atallah ÁN, Pinto ACPN, et al. COVID-19 and patients with immune-mediated inflammatory diseases undergoing pharmacological treatments: a rapid living systematic review. Sao Paulo Med J 2020;138:515-20. DOI: https://doi.org/10.1590/1516-3180.2020.0421.r2.10092020
Alzahrani ZA, Alghamdi KA, Almaqati AS. Clinical characteristics and outcome of COVID-19 in patients with rheumatic diseases. Rheumatol Int 2021;41:1097-103. DOI: https://doi.org/10.1007/s00296-021-04857-9
Agarwal V, Singh R, Chauhan S. Remission of rheumatoid arthritis after acute disseminated varicella-zoster infection. Clin Rheumatol 2007;26:779-80. DOI: https://doi.org/10.1007/s10067-005-0194-x
Sollini M, Gelardi F, Carlo-Stella C, Chiti A. Complete remission of follicular lymphoma after SARS-CoV-2 infection: from the "flare phenomenon" to the "abscopal effect". Eur J Nucl Med Mol Imaging 2021;48:2652-4. DOI: https://doi.org/10.1007/s00259-021-05275-6
Saricaoglu EM, Hasanoglu I, Guner R. The first reactive arthritis case associated with COVID-19. J Med Virol 2021;93:192-3. DOI: https://doi.org/10.1002/jmv.26296
Ono K, Kishimoto M, Shimasaki T, et al. Reactive arthritis after COVID-19 infection. RMD Open 2020;6:e001350. DOI: https://doi.org/10.1136/rmdopen-2020-001350
Jali I. Reactive arthritis after COVID-19 infection. Cureus 2020;12:e11761. DOI: https://doi.org/10.7759/cureus.11761
Perrot L, Hemon M, Busnel JM, et al. First flare of ACPA-positive rheumatoid arthritis after SARS-CoV-2 infection. Lancet Rheumatol 2021;3:e6-e8. DOI: https://doi.org/10.1016/S2665-9913(20)30396-9
Coath FL, Mackay J, Gaffney JK. Axial presentation of reactive arthritis secondary to COVID-19 infection. Rheumatology (Oxford) 2021;60:e232-e3. DOI: https://doi.org/10.1093/rheumatology/keab009
Rauber S, Luber M, Weber S, et al. Resolution of inflammation by interleukin-9-producing type 2 innate lymphoid cells. Nat Med 2017;23:938-44. DOI: https://doi.org/10.1038/nm.4373
Tang KT, Hsu BC, Chen DY. Autoimmune and rheumatic manifestations associated with COVID-19 in adults: An updated systematic review. Front Immunol 2021;12:645013. DOI: https://doi.org/10.3389/fimmu.2021.645013
Ehrenfeld M, Tincani A, Andreoli L, et al. Covid-19 and autoimmunity. Autoimmun Rev 2020;19:102597. DOI: https://doi.org/10.1016/j.autrev.2020.102597
Ajeganova S, Huizinga T. Sustained remission in rheumatoid arthritis: latest evidence and clinical considerations. Ther Adv Musculoskelet Dis 2017;9:249-62. DOI: https://doi.org/10.1177/1759720X17720366
George LJ, Philip AM, John KJ, et al. A review of the presentation and outcome of sarcoidosis in coronavirus disease 2019. J Clin Transl Res 2021;7:657-65.

How to Cite

Barman, Bhupen, Arvind Nune, Pranav Ish, Pranjal Phukan, Donboklang Lynser, and Hem Raj Sapkota. 2022. “Complete Persistent Remission of Rheumatoid Arthritis After COVID-19 Infection - A Rare Case and Literature Review”. Monaldi Archives for Chest Disease 93 (1). https://doi.org/10.4081/monaldi.2022.2195.