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Post-COVID-19 arthritis: is it hyperinflammation or autoimmunity?
BACKGROUND: Various musculoskeletal and autoimmune manifestations have been described in patients with coronavirus disease 2019 (COVID-19). OBJECTIVES: This study aims to investigate the prevalence and etiology of arthritis in post-COVID Egyptian patients. METHODS: We included 100 post-COVID Egyptia...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Libbey Eurotext
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8831681/ https://www.ncbi.nlm.nih.gov/pubmed/35118946 http://dx.doi.org/10.1684/ecn.2021.0471 |
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author | Taha, Sara Ibrahim Samaan, Sara Farid Ibrahim, Rehab Ali El-Sehsah, Eman Mousa Youssef, Mariam Karam |
author_facet | Taha, Sara Ibrahim Samaan, Sara Farid Ibrahim, Rehab Ali El-Sehsah, Eman Mousa Youssef, Mariam Karam |
author_sort | Taha, Sara Ibrahim |
collection | PubMed |
description | BACKGROUND: Various musculoskeletal and autoimmune manifestations have been described in patients with coronavirus disease 2019 (COVID-19). OBJECTIVES: This study aims to investigate the prevalence and etiology of arthritis in post-COVID Egyptian patients. METHODS: We included 100 post-COVID Egyptian patients who recovered 6 months ago and assessed several inflammatory and autoimmune markers. RESULTS: The prevalence of post-COVID arthritis was 37%. Ankle, knee, and wrist were the most commonly affected joints. Old age (P = 0.010), smoking (P = 0.001), and arthralgia (P = 0.049) were all linked with post-COVID arthritis. Levels of pretreatment (baseline) interleukin (IL)-6 (46.41 ± 3.67 vs. 24.03 ± 2.46; P = 0.001), as well as 6-month post-COVID C-reactive protein (CRP; 98.49 ± 67.55 vs. 54.32 ± 65.73; P = 0.002), and erythrocyte sedimentation rate (ESR; 109.08 ± 174.91 vs. 58.35 ± 37.87; P = 0.029) were significantly higher in patients with arthritis compared to those without. On the other hand, complement C3 (P = 0.558) and C4 (P = 0.192), anti-nuclear antibodies (P = 0.709), and anti-cyclic citrullinated peptides (anti-CCP; P = 0.855) did not show significant differences. Only pretreatment IL-6 level was the significant single predictor of post-COVID arthritis with an odds ratio (95% confidence interval) of 3.988 (1.460–10.892) and a P-value of 0.007. CONCLUSION: The strong association observed with inflammatory markers (ESR and CRP) and the insignificant association with serologic markers of autoimmunity (ANA and anti-CCP) in our study support the notion that the underlying mechanism of post-COVID-19 arthritis is primarily due to the hyperinflammatory process associated with COVID-19 infection, and not the result of an autoimmune reaction. IL-6 levels before therapy can predict post-COVID arthritis allowing for early management. |
format | Online Article Text |
id | pubmed-8831681 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Libbey Eurotext |
record_format | MEDLINE/PubMed |
spelling | pubmed-88316812022-02-18 Post-COVID-19 arthritis: is it hyperinflammation or autoimmunity? Taha, Sara Ibrahim Samaan, Sara Farid Ibrahim, Rehab Ali El-Sehsah, Eman Mousa Youssef, Mariam Karam Eur Cytokine Netw Research Article BACKGROUND: Various musculoskeletal and autoimmune manifestations have been described in patients with coronavirus disease 2019 (COVID-19). OBJECTIVES: This study aims to investigate the prevalence and etiology of arthritis in post-COVID Egyptian patients. METHODS: We included 100 post-COVID Egyptian patients who recovered 6 months ago and assessed several inflammatory and autoimmune markers. RESULTS: The prevalence of post-COVID arthritis was 37%. Ankle, knee, and wrist were the most commonly affected joints. Old age (P = 0.010), smoking (P = 0.001), and arthralgia (P = 0.049) were all linked with post-COVID arthritis. Levels of pretreatment (baseline) interleukin (IL)-6 (46.41 ± 3.67 vs. 24.03 ± 2.46; P = 0.001), as well as 6-month post-COVID C-reactive protein (CRP; 98.49 ± 67.55 vs. 54.32 ± 65.73; P = 0.002), and erythrocyte sedimentation rate (ESR; 109.08 ± 174.91 vs. 58.35 ± 37.87; P = 0.029) were significantly higher in patients with arthritis compared to those without. On the other hand, complement C3 (P = 0.558) and C4 (P = 0.192), anti-nuclear antibodies (P = 0.709), and anti-cyclic citrullinated peptides (anti-CCP; P = 0.855) did not show significant differences. Only pretreatment IL-6 level was the significant single predictor of post-COVID arthritis with an odds ratio (95% confidence interval) of 3.988 (1.460–10.892) and a P-value of 0.007. CONCLUSION: The strong association observed with inflammatory markers (ESR and CRP) and the insignificant association with serologic markers of autoimmunity (ANA and anti-CCP) in our study support the notion that the underlying mechanism of post-COVID-19 arthritis is primarily due to the hyperinflammatory process associated with COVID-19 infection, and not the result of an autoimmune reaction. IL-6 levels before therapy can predict post-COVID arthritis allowing for early management. John Libbey Eurotext 2022-02-11 2021 /pmc/articles/PMC8831681/ /pubmed/35118946 http://dx.doi.org/10.1684/ecn.2021.0471 Text en © JLE/Springer 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Research Article Taha, Sara Ibrahim Samaan, Sara Farid Ibrahim, Rehab Ali El-Sehsah, Eman Mousa Youssef, Mariam Karam Post-COVID-19 arthritis: is it hyperinflammation or autoimmunity? |
title | Post-COVID-19 arthritis: is it hyperinflammation or autoimmunity? |
title_full | Post-COVID-19 arthritis: is it hyperinflammation or autoimmunity? |
title_fullStr | Post-COVID-19 arthritis: is it hyperinflammation or autoimmunity? |
title_full_unstemmed | Post-COVID-19 arthritis: is it hyperinflammation or autoimmunity? |
title_short | Post-COVID-19 arthritis: is it hyperinflammation or autoimmunity? |
title_sort | post-covid-19 arthritis: is it hyperinflammation or autoimmunity? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8831681/ https://www.ncbi.nlm.nih.gov/pubmed/35118946 http://dx.doi.org/10.1684/ecn.2021.0471 |
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