How long is long COVID

disease or discuss the third scenario, which is musculoskeletal manifestations of long COVID.

Purpose of the study. To study the frequency and structure of postcovid syndrome (PCS) in patients with rheumatic diseases (RD).Materials and methods. The study included 70 patients with RD who had a coronavirus infection during the year. A questionnaire was carried out on the severity of the coronavirus infection, persisting symptoms in the postcovid period. Questionnaires of anxiety and depression, sleep quality were used, the activity of RD was assessed.Results. Manifestations of PCS occurred in 50 (71 %) patients, of which 47 (67 %) had 2 or more manifestations. PCS was observed equally often in patients with different severity of infection. Such the symptoms of PCS as weakness, arthralgia, increased blood pressure, shortness of breath, tachycardia prevailed during 3 months after COVID-19. Half of the patients had a decrease in the severity of weakness, arthralgia and shortness of breath after 6 months, but the destabilization of blood pressure and tachycardia remained at the same level. Such the psychoemotional manifestations of PCS as moderate depression, memory impairment, insomnia were observed.Conclusions. More than 2/3 of patients with RS who have undergone COVID-19 are faced with PKS. In 1/3 of the examined patients with RD the duration of the persistence of symptoms of PCS exceeds 6 months after infection. After revealing of blood pressure destabilization in patients with rheumatic diseases, it is advisable to assess cardiovascular risks in patients who have undergone COVID-19.

Features of postcovid syndrome in patients with rheumatic diseases

Zusammenfassung Sowohl nach COVID-Infektion als auch nach ein oder mehreren COVID-Impfungen können rheumatische Beschwerden beginnen. In beiden Fällen scheint der Mechanismus ähnlich zu sein und mit dem Coronavirus oder seinen spezifischen Folgen zusammenzuhängen. Zumeist wird von einer reaktiven Arthritis gesprochen, wenngleich die Bezeichnung COVID-19-assoziierte Arthritis für das Beschwerdebild eher zutreffen dürfte. In Relation zur Zahl der COVID-Infizierten und der COVID-geimpften ist die Zahl der Fälle, in denen es zu COVID-assoziierten Beschwerden kommt, außerordentlich gering und die Prognose scheint eher gut zu sein. 

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Rheuma nach COVID-19-Infektion oder Impfung

The current systematic review aimed to document published cases of femoral head avascular necrosis (FHAVN) post-COVID-19, to report the COVID-19 disease characteristics and management patients received, and to evaluate how the FHAVN were diagnosed and treated among various reports. A systematic literature review was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines through a comprehensive English literature search on January 2023 through four databases (Embase, PubMed, Cochrane Library, and Scopus), including studies reporting on FHAVN post-COVID-19. Fourteen articles were included, ten (71.4%) were case reports, and four (28.6%) case series reported on 104 patients having a mean age of 42.2 ± 11.7 (14:74) years, in which 182 hip joints were affected. In 13 reports, corticosteroids were used during the COVID-19 management plan for a mean of 24.8 ± 11 (7:42) days, with a mean prednisolone equivalent dose of 1238.5 ± 492.8 (100:3520) mg. A mean of 142.1 ± 107.6 (7:459) days passed between COVID-19 diagnosis and FHAVN detection, and most of the hips were stage II (70.1%), and concomitant septic arthritis was present in eight (4.4%) hips. Most hips (147, 80.8%) were treated non-surgically, of which 143 (78.6%) hips received medical treatment, while 35 (19.2%) hips were surgically managed, 16 (8.8%) core decompression, 13 (7.1%) primary THA, five (2.7%) staged THA and three (1.6%) had first stage THA (debridement and application of antibiotic-loaded cement spacer). The outcomes were acceptable as regards hip function and pain relief. Femoral head avascular necrosis post-COVID-19 infection is a real concern, primarily attributed to corticosteroid usage, besides other factors. Early suspicion and detection are mandatory, as conservative management lines are effective during early stages with acceptable outcomes. However, surgical intervention was required for progressive collapse or patients presented in the late stage. 

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Femoral head avascular necrosis in COVID-19 survivors: a systematic review

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Arthritis after SARS-CoV-2 infection: reactive arthritis or virally mediated arthritis?

In the third year of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2, COVID-19) pandemic doctors are encountering a new pathology – post-COVID-19 syndrome (PCS, long covid). Musculoskeletal manifestations are among the most common and may present as myalgia, arthralgia, or arthritis. Currently, there is no generally accepted definition of the disease, its duration, classification, or diagnostic criteria, and no single view on the “content” of musculoskeletal manifestations of PCS. We have enough descriptions of the debut of rheumatoid arthritis (RA) after SARS-CoV-2. That is a question: it is a coincidence, or COVID-19 may be a trigger factor of RA? We thought that SARS-CoV-2 infection may be a trigger factor for new rheumatic musculoskeletal diseases, including rheumatoid arthritis or COVID-19 can unmask previously undetected RA. The occurrence of arthritis may be a sign of PCS with transient character. So arthritis in the post covid period may induce problems in differential diagnosis of rheumatic diseases. 

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Rheumatoid arthritis and post-COVID-19 syndrome

/pdf/osteonecrosis-amid-the-covid-19-pandemic-1432c5b4.pdf

A. Botabekova

Papers

Arthritis after SARS-CoV-2 infection: reactive arthritis or virally mediated arthritis?

Rheumatoid arthritis and post-COVID-19 syndrome

Osteonecrosis amid the COVID-19 pandemic