#MTP SYNOVITIS SERIES#
To the best of our knowledge, this is the first case series of patients who recovered from COVID-19 developing bilaterally symmetrical polyarthritis which phenotypically resembled rheumatoid arthritis. The musculoskeletal ultrasound scan showed evidence of symmetrical synovitis. The patient characteristics and findings are summarized in Table 1. All patients were suffering from polyarthritis showing symmetrical distribution, including large and small joints. These patients presented to the rheumatology outpatient clinic complaining of new-onset joint pain after recovering from SARS-CoV-2 infection. The current literature on inflammatory manifestations, especially symmetrical polyarthritis, is scarce. We hereby present a case series of 5 patients who presented with inflammatory arthritis (symmetrical/polyarticular) as a sequela of COVID-19 infection. Therefore, the persistence of musculoskeletal complaints is even more worrying because it may indicate that inflammatory reactions can overcome the anti-inflammatory effects of these drugs. The use of nonsteroidal anti-inflammatory drugs (NSAIDS) is very common in COVID-19. According to it, myalgias (23.8%) were not uncommon among 393 patients. An article published in the New England Journal of Medicine discussed the clinical characteristics of COVID-19 in New York City. It was seen that after cough, fatigue (73%) was the most common symptom in these patients. Another city in China, Chengdu, evaluated the epidemiological characteristics of 99 test-positive cases who were admitted to the hospital. Nearly two-thirds of patients had myalgia or fatigue. A retrospective single-center analysis conducted in Wuhan, China, included 84 confirmed cases of SARS-CoV-2 infection. Eight studies reported having a prevalence of greater than 50% of patients with fatigue while three reported higher values of arthralgia/myalgia. It included a total of 54 studies (12,045 patients), mostly from China, and found that, amongst the musculoskeletal symptoms, fatigue and arthralgia/myalgia were the most common symptoms. Ī very recent study collected data of the past 5 months, from different studies published worldwide, to detect the frequency of musculoskeletal symptoms in COVID-19 patients. Fatigue, arthralgia, and myalgia have been identified as common COVID-19 symptoms with considerable musculoskeletal dysfunction in some patients, but long-term follow-up and their prevalence have yet not been investigated. The virus mainly affects the respiratory system but has indirect effects on multiple organ systems including the musculoskeletal system. Coronavirus disease 2019 (COVID-19) is an emerging pandemic that is caused by severe acute respiratory distress coronavirus 2 (SARS-CoV-2).
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