Table 3.
COVID-19-associated arthritis with onset up to 1 week after COVID-19 initial manifestations
| Study, country | N, gender, age (years) | COVID-19 symptoms | Time between onset of COVID-19 and onset of articular symptoms (SARS-CoV-2 diagnostic test) | Type of arthritis (and EA involvement) | Blood tests (included immunology) | Serologies | Arthrocentesis | Treatment for COVID-19 | Treatment for arthritis | Last assessment and chronicity |
| Alivernini et al11, Italy | 1, male, 61 | Cough, mild dyspnoea, severe asthenia and anorexia | Concomitant (RT-PCR) | Polyarthritis | RF and ACPA negative | NA | Absence of calcium pyrophosphate or monosodium urate crystals | Lopinavir-ritonavir and HCQ 400 mg/day | Etoricoxib 200 mg/day, baricitinib 4 mg/day, PDN 10 mg/day | Symptoms resolved (DAS28-CRP: 2.8 after 8 days) |
| Apaydin et al, Turkey | 1, male, 37 | Watery diarrhoea and dry cough | 1 week (nasopharyngeal and oropharyngeal swab RT-PCR) | Polyarthritis (knees, wrists, ankles, elbows and MTP joints) | Normal UA; RF, ASO, ANCA, ACPA, ANA and ENA negative; HLA-B27 positive |
HBV, HCV, HIV, EBV, HSV type 1 and 2, parvovirus B19, rubella, CMV, toxoplasma, brucellosis, syphilis and gonorrhoea negative | 617 leucocytes/mm3, with negative Gram staining and bacterial cultures | NA | HCQ 400 mg/day and MPD 16 mg/day; SSZ 2 g/day | Chronic symptoms (arthralgia) |
| Houshmand et al9, Iran | 1, male, 10 | Fever, urticaria | 2 days (nasopharyngeal and oropharyngeal swab RT-PCR) | Knees and right elbow | RF, ANA negative | Urine analysis was normal; stool examinations for ova and parasites and occult blood were normal | Dry tap without any joint fluid | Acetaminophen, cetirizine 10 mg/day, desloratadine 5 mg/day, hydroxyzine 10 mg/day | Not used | No chronicity |
| Liew et al13, Singapore | 1, male, 47 | Low-grade fever | 3 days (nasopharyngeal and oropharyngeal swab RT-PCR) | Knee and balanitis | NA | HIV, syphilis, chlamydia and gonorrhoea testing were negative | Turbid yellow fluid, without crystals; synovial Gram stain, gonococcal, bacteria cultures and gonococcal and chlamydia PCR were negative; synovial fluid PCR and viral cultures for SARS CoV-2 were also negative | NA | Etoricoxib and intra-articular triamcinolone (knee joint) | Remission |
| Sinaei et al10, Iran | 1, male, 8 | Low-grade fever and cough | 1 week (COVID-19 IgM indirect ELISA) | Hip | NA | UA normal, ANA negative; RF positive | NA | NA | Skin traction and naproxen 500 mg/day | No chronicity |
| 1, female, 6 | High-grade fever | 1 week (nasopharyngeal and oropharyngeal swab RT-PCR) | Hips | NA | UA normal, RF and ANA negative | NA | NA | Ibuprofen 40 mg/kg/day in three doses/day | Complete recovery after 4 days | |
| Talarico et al14, Italy | 1, male, 45 | Anosmia, dysgeusia and myalgia without any respiratory symptoms | 1 week before other COVID-19 symptoms (nasopharyngeal and oropharyngeal swab RT-PCR) | Symmetric polyarthritis (MCP, PIP) | ACPA positive; RF negative | NA | NA | No specific treatment | Medium doses of MPD | Complete remission |
ACPA, anticitrullinated protein antibodies; ANA, antinuclear antibodies; ANCA, antineutrophil cytoplasmic antibodies; ASO, antistreptolysin O; CMV, cytomegalovirus; CRP, C reactive protein; DAS28, Disease Activity Score 28 joints; EA, extra-articular; EBV, Epstein-Barr virus; ENA, extractable nuclear antigen; HBV, hepatitis B virus; HCQ, hydroxychloroquine; HCV, hepatitis C virus; HLA, human leucocyte antigen; HSV, herpes simplex virus; MCP, metacarpophalangeal; MPD, methylprednisolone; MTP, metatarsophalangeal; NA, not available; PDN, prednisolone; PIP, proximal interphalangeal; RF, rheumatoid factor; RT-PCR, real-time PCR; SSZ, sulfasalazine; UA, uric acid.