背景:反应性关节炎(ReA)是一种在远处感染后的关节炎症,通常在胃肠道或泌尿生殖道。自2020年1月COVID-19出现以来,一些病例报告表明反应性关节炎与严重急性呼吸道综合征冠状病毒2(SARS-COV-2)之间存在关系,由于这种疾病的新颖性,大多数发现以病例报告或病例系列的形式报告,仍然缺乏全面的概述。
方法:我们搜索了PubMed/Medline和Embase,以确定针对ReA和COVID-19之间关联的研究。使用了以下术语:(\“反应性关节炎\”或\“感染后关节炎\”或\“感染后关节炎\”)和(\“COVID-19\”或\“SARS-CoV-2\”或\“2019-nCoV\”)。
结果:截至2月16日,共发布了35份报告,2022年被纳入本研究。受影响的年龄范围很广(平均41.0,最小4最大78),来自16个国家的男性患病率较高(61.0%)。纳入患者受影响关节的数量和位置不同,所有病例中41.5%的多关节炎患病率较高。发现皮肤表现和视觉障碍是最常见的相关症状。大多数患者(95.1%)康复,平均恢复时间为24天。此外,由COVID-19引起的关节炎似乎比ReA缓解得更快,其次是其他感染。
结论:ReA可能是COVID-19感染的后遗症。由于肌肉骨骼疼痛是COVID-19的常见症状,起病迅速的ReA容易被误诊。因此,临床医生应将ReA视为COVID-19后关节肿胀患者的重要鉴别诊断。需要进一步的研究来进一步分析和证实这些发现。
BACKGROUND: Reactive arthritis (ReA) is a joint inflammation that follows an infection at a distant site, often in the gastrointestinal or urogenital tract. Since the emergence of COVID-19 in January 2020, several
case reports have suggested a relation between reactive arthritis and severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), due to the novelty of the disease, most findings were reported in the form of
case reports or
case series, and a comprehensive overview is still lacking.
METHODS: We searched PubMed/Medline and Embase to identify studies addressing the association between ReA and COVID-19. The following terms were used: (\"Reactive Arthritis\" OR \"Post-Infectious Arthritis\" OR \"Post Infectious Arthritis\") AND (\"COVID-19\" OR \"SARS-CoV-2\" OR \"2019-nCoV\").
RESULTS: A total number of 35
reports published up to February 16th, 2022, were included in this study. A wide range of ages was affected (mean 41.0, min 4 max 78), with a higher prevalence of males (61.0%) from 16 countries. The number and location of the affected joints were different in included patients, with a higher prevalence of polyarthritis in 41.5% of all cases. Cutaneous manifestations and visual impairments were found as the most common associated symptoms. Most patients (95.1%) recovered, with a mean recovery time of 24 days. Moreover, arthritis induced by COVID-19 seems to relieve faster than ReA, followed by other infections.
CONCLUSIONS: ReA can be a possible sequel of COVID-19 infection. Since musculoskeletal pain is a frequent symptom of COVID-19, ReA with rapid onset can easily be misdiagnosed. Therefore, clinicians should consider ReA a vital differential diagnosis in patients with post-COVID-19 joint swelling. Additional studies are required for further analysis and to corroborate these findings.