Rheumatological manifestations of post-COVID syndrome (literature review)
https://doi.org/10.33667/2078-5631-2022-15-20-25
Abstract
To date, the main resonance is caused by studies of the so-called post-COVID syndrome, which can occur even in patients who have had mild or moderate COVID-19. The present review provides a historical background on the origin of this term, considers the most common rheumatological manifestations of post-COVID syndrome, including arthralgia, rash, perniosis, dyspnea, fatigue, fibromyalgia, the formation of autoantibodies and markers of systemic inflammation. The review also provides current views on the treatment of post-COVID syndrome. The authors emphasize the need for differential diagnosis between rheumatological manifestations of post-COVID syndrome and the onset of rheumatic disease after COVID-19, and substantiate a multidisciplinary approach to therapy methods.
About the Authors
E. S. Aronova
V. A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Aronova Evgenia S., PhD Med, researcher at Laboratory for the Study of Comorbid Infections and Vaccination
Moscow
B. S. Belov
V. A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Belov Boris S., DM Sci (habil.), head of Laboratory for the Study of Comorbid Infections and Vaccination
Moscow
G. I. Gridneva
V. A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Gridneva Galina I., PhD Med, researcher at Laboratory for the Study of Comorbid Infections and Vaccination
Moscow
References
1. Bliddal S., Banasik K., Pedersen O. B. et al. Acute and persistent symptoms in non-hospitalized PCR-confirmed COVID-19 patients. Sci Rep. 2021. 11. 13153. DOI: 10.1038/s41598–021–92045-x.
2. Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK: 1/06/2022. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/6january2022
3. Perego E, Callard F, Stras L, et al. Why we need to keep using the patient made term “Long Covid”. Available at: https://blogs.bmj.com/bmj/2020/10/01/whywe-need-to-keep-using-the-patient-made-term-long-covid/ (1 October 2020)
4. Patients’ experiences of “longcovid” are missing from the NHS narrative. Available at: https://blogs.bmj.com/bmj/2020/07/10/patients-experiences-of-long-covid-are-missing-from-the-nhs-narrative/
5. Covid - 19: What do we know about “long covid”? BMJ 2020; 370: m2815. https://doi.org/10.1136/bmj.m2815
6. National Institute for Health and Care Excellence. COVID-19 rapid guideline: managing the long-term effects of COVID-19. NICE guideline [NG188]. Available at: https://www.nice.org.uk/guidance/ng188 (18 December 2020)
7. Nalbandian A., Sehgal K., Gupta A., et al. Post-acute COVID-19 syndrome. Nat Med 2021; 27: 601–615. DOI: 10.1038/s41591–021–01283-z
8. Al-Aly Z., Xie Y., Bowe B. High-dimensional characterization of post-acute sequelae of COVID-19. Nature 2021; 594: 259–264. DOI: 10.1038/s41586–021–03553–9.
9. Phillips S., Williams M. A. Confronting our next national health disaster – long-haul Covid. N Engl J Med 2021; 385: 577–579. DOI: 10.1056/NEJMp2109285.
10. World Health Organisation (WHO). A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021. Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition_Clinical_case_definition-2021.1.
11. Parums D. V. Editorial: Long COVID, or Post-COVID Syndrome, and the Global Impact on Health Care. Med Sci Monit. 2021; 27: e933446. DOI: 10.12659/MSM.933446.
12. Ghosn J., Piroth. L., Epaulard O., et al. Persistent COVID-19 symptoms are highly prevalent 6 months after hospitalization: results from a large prospective cohort. Clin Microbiol Infect. 2021 Jul; 27 (7): 1041. e1–1041.e4. DOI: 10.1016/j.cmi.2021.03.012.
13. González-Hermosillo J.A., Martínez-López J.P., Carrillo-Lampón S.A., et al. PostAcute COVID-19 Symptoms, a Potential Link with Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome: A 6-Month Survey in a Mexican Cohort. Brain Sci. 2021 Jun 8; 11 (6): 760. DOI: 10.3390/brainsci11060760.
14. Fortini A., Torrigiani A., Sbaragli S., et al. COVID-19: persistence of symptoms and lung alterations after 3–6 months from hospital discharge. Infection. 2021 Oct; 49 (5): 1007–1015. DOI: 10.1007/s15010–021–01638–1.
15. Karaarslan F., Güneri F. D., Kardeş S. Long COVID: rheumatologic/ musculoskeletal symptoms in hospitalized COVID-19 survivors at 3 and 6 months. Clin Rheumatol. 2022; 41 (1): 289–296. DOI: 10.1007/s10067–021–05942-x.
16. Carfì A., Bernabei R., Landi F. Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 202; 324 (6): 603–605. DOI: 10.1001/jama.2020.12603.
17. Garrigues E., Janvier P., Kherabi Y., et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect. 2020; 81 (6): e4–e6. DOI: 10.1016/j.jinf.2020.08.029.
18. Huang C., Huang L., Wang Y., et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021; 397 (10270): 220–232. DOI: 10.1016/S0140–6736(20)32656–8.
19. Moreno-Pérez O., Merino E., Leon-Ramirez J.M., et al. Post-acute COVID-19 syndrome. Incidence and risk factors: A Mediterranean cohort study. J Infect. 2021; 82 (3): 378–383. DOI: 10.1016/j.jinf.2021.01.004.
20. Goërtz Y. M.J., Van Herck M., Delbressine J. M., et al. Persistent symptoms 3 months after a SARS-CoV-2 infection: the post-COVID-19 syndrome? ERJ Open Res. 2020; 6 (4): 00542–2020. DOI: 10.1183/23120541.00542–2020.
21. Peghin M., Palese A., Venturini M., et al. Post-COVID-19 symptoms 6 months after acute infection among hospitalized and non-hospitalized patients. Clin Microbiol Infect. 2021; 27 (10): 1507–1513. DOI: 10.1016/j.cmi.2021.05.033.
22. Sykes D. L., Holdsworth L., Jawad N., et al. Post-COVID-19 Symptom Burden: What is Long-COVID and How Should We Manage It? Lung. 2021; 199 (2): 113–119. DOI: 10.1007/s00408–021–00423-z.
23. Lopez-Leon S., Wegman-Ostrosky T., Perelman C., et al. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 2021; 11 (1): 16144. DOI: 10.1038/s41598–021–95565–8.
24. Petersen M. S., Kristiansen M. F., Hanusson K. D. et al. Long COVID in the Faroe Islands – a longitudinal study among non-hospitalized patients. Clin Infect Dis. 2021; 73 (11): e4058–e4063. DOI: 10.1093/cid/ciaa1792.
25. Ono K., Kishimoto M., Shimasaki T. et al. Reactive arthritis after COVID-19 infection. RMD Open. 2020; 6 (2): e001350. DOI: 10.1136/rmdopen-2020–001350.
26. Gasparotto M., Framba V., Piovella C., et al. Post-COVID-19 arthritis: a case report and literature review. Clin Rheumatol. 2021; 40 (8): 3357–3362. DOI: 10.1007/s10067–020–05550–1.
27. Hønge B. L., Hermansen M. F., Storgaard M. Reactive arthritis after COVID-19. BMJ Case Rep. 2021. Vol. 14. Issue 3. P. e241375. DOI: 10.1136/bcr-2020–241375.
28. Aronova E. S., Belov B. S. Polyarthritis associated with COVID-19 (clinical case). Modern rheumatology. 2021. No. 15. Volume 5. P. 76–79. DOI: 10.14412/1996–7012–2021–5–76–79.
29. Derksen V. F., Kissel T., Lamers-Karnebeek F.B. et al. Onset of rheumatoid arthritis after COVID-19: coincidence or connected? Ann Rheum Dis. 2021. Vol. 80. P. 1096–1098. DOI: 10.1136/annrheumdis-2021–219859.
30. Roongta R., Chattopadhyay A., Ghosh A. Correspondence on ‘Onset of rheumatoid arthritis after COVID-19: coincidence or connected?’ Ann Rheum Dis. 2021. epub ahead of print. DOI: 10.1136/annrheumdis-2021–220479.
31. Lerma L. A., Chaudhary A., Bryan A., Morishima C., Wener M. H., Fink S. L. Prevalence of autoantibody responses in acute coronavirus disease 2019 (COVID-19). J Transl Autoimmun. 2020. Vol. 3. P. 100073. DOI: 10.1016/j.jtauto.2020.100073.
32. Cares-Marambio K., Montenegro-Jiménez Y. et al. Prevalence of potential respiratory symptoms in survivors of hospital admission after coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis. Chron Respir Dis. 2021. Vol. 18. P. 14799731211002240. DOI: 10.1177/14799731211002240.
33. Wu X., Liu X., Zhou Y. et al. 3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study. Lancet Respir Med. 2021. Vol. 9. Issue 7. P. 747–754. DOI: 10.1016/S2213–2600(21)00174–0.
34. Dani M., Dirksen A., Taraborrelli P. et al. Autonomic dysfunction in 'long COVID': rationale, physiology and management strategies. Clin med (Lond). 2021. Vol. 21. Issue 1. P. e63–e67. DOI: 10.7861/clinmed.2020–0896.
35. George P. M., Barratt S. L., Condliffe R. et al. Respiratory follow-up of patients with COVID-19 pneumonia. Thorax. 2020. Vol. 75. P. 1009–1016. DOI: 10.1136/thoraxjnl-2020–215314.
36. McMahon D.E., Gallman A. E., Hruza G. J. et al. Long COVID in the skin: a registry analysis of COVID-19 dermatological duration. Lancet Infect Dis. 2021. Vol. 21. Issue 3. P. 313–314. DOI: 10.1016/S1473–3099(20)30986–5.
37. Mehta P., Bunker C. B., Ciurtin C. et al. Chilblain-like acral lesions in long COVID-19: management and implications for understanding microangiopathy. Lancet Infect Dis. 2021. Vol. 21. Issue 7. P. 912. DOI: 10.1016/S1473–3099(21)00133-X.
38. Mohabbat A. B., Mohabbat N. M.L., Wight E. C. Fibromyalgia and chronic fatigue syndrome in the age of COVID-19. Mayo Clin Proc Innov Qual Outcomes. 2020. Vol. 4. Issue 6. P. 764–766. DOI: 10.1016/j.mayocpiqo.2020.08.002.
39. Clauw D., Häuser W., Cohen S., Fitzcharles M. Considering the potential for an increase in chronic pain after the COVID-19 pandemic. Pain. 2020. Vol. 161. Issue 8. P. 1694–1697. DOI: 10.1097/j.pain.0000000000001950.
40. Wong T. L., Weitzer D. J. Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)-a systemic review and comparison of clinical presentation and symptomatology. Medicina (Kaunas). 2021. Vol. 57. Issue 5. P. 418. DOI: 10.3390/medicina57050418.
41. Graham E. L., Clark J. R.., Orban ZS. et al. Persistent neurologic symptoms and cognitive dysfunction in non-hospitalized Covid-19 “long haulers”. Ann Clin Transl Neurol. 2021. Vol. 8. Issue 5. P. 1073–1085. DOI: 10.1002/acn3.51350.
42. Dotan A., Shoenfeld Y. Post-COVID syndrome: The aftershock of SARS-CoV-2. Int. J. Infect. Dis. 2021; 114: 233–235. DOI: 10.1016/j.ijid.2021.11.020.
43. Ursini F., Ciaffi J., Mancarella L. et al. Fibromyalgia: a new facet of the postCOVID-19 syndrome spectrum? Results from a web-based survey. RMD Open. 2021. Vol. 7. P. e001735. DOI: 10.1136/rmdopen-2021–001735.
44. Salaffi F., Giorgi V., Sirotti S., Bongiovanni S. et al. The effect of novel coronavirus disease-2019 (COVID-19) on fibromyalgia syndrome. Clin. Exp. Rheumatol. 2021; 39: 72–77. PMID: 33200740.
45. Dinerman H., Goldenberg D. L., Felson D. T. A prospective evaluation of 118 patients with the fibromyalgia syndrome: Prevalence of Raynaud’s phenomenon, sicca symptoms, ANA, low complement, and Ig deposition at the dermal-epidermal junction. J. Rheumatol. 1986; 13: 368–373. PMID: 3487650.
46. Kötter I., Neuscheler D., Günaydin I., Wernet D., Klein R. Is there a predisposition for the development of autoimmune diseases in patients with fibromyalgia? Retrospective analysis with long term follow-up. Rheumatol. Int. 2007; 27: 1031–1039. DOI: 10.1007/s00296–007–0413–7.
47. Dönmez S., Pamuk Ö. N., Ümit E. G., Top M. Ş. Autoimmune rheumatic disease associated symptoms in fibromyalgia patients and their influence on anxiety, depression and somatisation: A comparative study. Clin. Exp. Rheumatol. 2012; 30: 65–69. PMID: 23137613.
48. Hafiz W., Nori R., Bregasi A., Noamani B., Bonilla D. et al. Fatigue severity in anti-nuclear antibody-positive individuals does not correlate with pro-inflammatory cytokine levels or predict imminent progression to symptomatic disease. Arthritis Res. 2019; 21: 1–11. DOI: 10.1186/s13075–019–2013–9.
49. Peker B. O., Şener A. G., Kaptan Aydoğmuş F. Antinuclear antibodies (ANAs) detected by indirect immunofluorescence (IIF) method in acute COVID-19 infection; future roadmap for laboratory diagnosis. J. Immunol. Methods. 2021; 499: 113174. DOI: 10.1016/j.jim.2021.113174.
50. Goebel A., Krock E., Gentry C. et al. Passive transfer of fibromyalgia symptoms from patients to mice. J Clin Invest. 2021 Jul 7; 131 (13). DOI: 10.1172/JCI144201.
51. Pascolini S., Vannini A., Deleonardi G. et al. COVID-19 and Immunological Dysregulation: Can Autoantibodies be Useful? Clin Transl Sci. 2021. Vol. 14. Issue 2. P. 502–508. DOI: 10.1111/cts.12908.
52. Vlachoyiannopoulos P. G., Magira E., Alexopoulos H. et al. Autoantibodies related to systemic autoimmune rheumatic diseases in severely ill patients with COVID-19. Ann Rheum Dis. 2020. Vol. 79. P. 1661–1663. DOI: 10.1136/annrheumdis-2020–218009.
53. Litwin C. M., Binder S. R. ANA testing in the presence of acute and chronic infections. J Immunoassay Immunochem. 2016. Vol. 37. Issue 5. P. 439–452. DOI: 10.1080/15321819.2016.1174136.
54. Callow K. A., Parry H. F., Sergeant M., Tyrrell D. A. The time course of the immune response to experimental coronavirus infection of man. Epidemiol Infect. 1990. Vol. 105. Issue 2. P. 435–446. DOI: 10.1017/s0950268800048019.
55. Liao B., Liu Z., Tang L. et al. Longitudinal clinical and radiographic evaluation reveals interleukin-6 as an indicator of persistent pulmonary injury in COVID-19. Int J Med Sci. 2021. Vol. 18. Issue 1. P. 29–41. DOI: 10.7150/ijms.49728.
56. Marvisi M., Ferrozzi F., Balzarini, et al. First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: factors predicting fibrotic evolution. Int J Infect Dis. 2020. Vol. 99. P. 485–488. DOI: 10.1016/j.ijid.2020.08.054.
57. Grech S., Borg J. N., Cuschieri S. Back pain: An aftermath of Covid-19 pandemic? A Malta perspective. Musculoskeletal Care. 2021. Epub ahead of print. P. 1–6. DOI: 10.1002/msc.1574.
58. Kamal M., Abo Omirah M., Hussein A., Saeed H. Assessment and characterisation of post-COVID-19 manifestations. Int J Clin Pract. 2021. Vol. 75. P. e13746. DOI: 10.1111/ijcp.13746.
59. Sudre C. H., Murray B., Varsavsky T., et al. Attributes and predictors of long COVID. Nat Med. 2021. Vol. 27. P. 626–31. DOI: 10.1038/s41591–021–01292-y.
60. UK Office for National Statistics. Prevalence of long COVID symptoms and COVID-19 complications. 2020. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/datasets/prevalenceoflongcovidsymptomsandcovid19complications
61. Halpin S. J., McIvor C., Whyatt G. et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: a cross-sectional evaluation. J Med Virol. 2021. Vol. 93. Issue 2. P. 1013–1022. DOI: 10.1002/jmv.26368.
62. Nasonov E. L., Lila A. M., Mazurov V. I. et al. Coronavirus disease 2019 (COVID-19) and immunoinflammatory rheumatic diseases. Recommendations of the All-Russian public organization «Association of Rheumatologists of Russia». Scientific and Practical Rheumatology. 2021; 59 (3): 239–254.
63. Guidelines. Features of the course of Long-COVID infection. Therapeutic and rehabilitation measures. Ed. acad. Martynova A. I. Available at: https://www.rnmot.ru/public/uploads/2022/rnmot/%D0%9C%D0%95%D0%A2%D0%9E%D0%94%D0%98%D0%A7%D0%95%D0%A1%D0%9A%D0%98%D0%95%20%D0%A0%D0%95%D0%9A%D0%9E%D0%9C%D0%95%D0%9D%D0%94%D0%90%D0%A6%D0%98%D0%98.pdf
Review
For citations:
Aronova E.S., Belov B.S., Gridneva G.I. Rheumatological manifestations of post-COVID syndrome (literature review). Medical alphabet. 2022;(15):20-25. (In Russ.) https://doi.org/10.33667/2078-5631-2022-15-20-25
Views:
533
Email this article 