Post-COVID musculo-articular syndrome and COVID-19 association with rheumatoid arthritis

Abstract

Introduction. Since the COVID-19 pandemic, there has been a great deal of evidence for a variety of post-COVID symptoms, including the presence of a musculo-articular syndrome. The aim of the study was to analyze the current literature data on the prevalence of musculo-articular syndrome and to study the association of coronavirus infection with the development of rheumatoid arthritis. Materials and methods. We searched PubMed, Medline, and Google Scholar (2020-2022) for articles using the following keywords: post-covid syndrome, muscular articular syndrome or muscle and joint pain, COVID-19, SARS-CoV-2, rheumatoid arthritis. We found 622 articles in which these words appeared in the text of the article. Further, 497 articles were excluded as irrelevant to the topic of the study. During the study of the remaining articles, special attention was paid to the occurrence of musculo-articular syndrome after COVID-19 infection and the association with rheumatoid arthritis. Results and discussion. There are studies describing musculo-articular pain syndrome and cases of antibodies to cyclic citrullinated peptide (ACCP) after COVID-19, which may indirectly indicate the development of rheumatoid arthritis in these patients. Studies reflect the increased autoreactivity of the immune system in COVID-19, consisting in increased titers of antinuclear antibodies, anti-cardiolipin antibodies, ACCP, and rheumatoid factor. A number of articles have presented results on the association between COVID-19 infection and the appearance, or exacerbation, of rheumatoid arthritis. Several mechanisms are discussed, presumably leading to the occurrence of post-COVID rheumatoid arthritis: induction by coronavirus of excess synthesis of angiotensin II, which increases the expression of inflammatory cytokines, chemokines and production of reactive oxygen species; activation of proinflammatory T-cell subpopulations; activation of Toll-like receptor-7 synovial membrane triggering the inflammatory response; "cytokine storm". Conclusion. A high percentage (from 15 to 47.7 %) of cases of musculo-articular lesions after COVID-19 infection has been identified. A number of articles have reported an association between COVID-19 infection and the onset, or exacerbation, of rheumatoid arthritis, but the issue is still under discussion, which necessitates large-scale studies specifically devoted to examining this association.