Inflammatory arthritis in patients with COVID-19
Richard Conway, Maximilian F. Konig, Elizabeth R. Graef, Kate Webb, Jinoos Yazdany, Alfred H.J. Kim
Abstract
Patients with inflammatory arthritis represent a possible high-risk group to COVID-19 due to their immunosuppressive regimen designed to maintain low disease activity. Thus, substantial effort has been put forth to understand the impact of COVID-19 on these patients. Patients with rheumatic diseases as a whole do not appear to be more susceptible to acquiring COVID-19. Furthermore, immunosuppression generally did not increase the likelihood of developing severe COVID-19, with the important exception of medium and high-dose glucocorticoid use. In addition, a small number of COVID-19 patients have developed new inflammatory arthritis; whether this represents an unmasking of previous subclinical disease or a bone fide virusinduced arthritis is unclear. Nevertheless, it appears that inflammatory arthritis patients currently on immunosuppression should continue their medication to prevent future flares and limit glucocorticoid usage. While this continues to be a rapidly evolving field, these data are reassuring to both patients with and providers treating inflammatory arthritides. (Translational Research 2021; 232:4959) Abbreviations: ACE-2 = Angiotensin converting enzyme-2; ACR = American College of Rheumatology; C1 = Complement component 1; CI = Confidence interval; COVID-19 = Coronavirus disease-2019; DMARD = Disease-modifying antirheumatic drugs; EULAR