Table 2 Overview of the pharmacological management, body location, and main findings of the included studies
From: Reactive arthritis following COVID-19 current evidence, diagnosis, and management strategies
Author and year | Treatment OA | Location OA | Main results of the study |
|---|---|---|---|
Baimukhamedov et al. 2021 [2] | 15 mg methotrexate weekly, 8 mg methylprednisolone daily | Knee, hand | Presence of autoantibodies after COVID-19 infection might suggest that this virus might also act as a trigger of reactive arthritis |
Basheikh et al. 2022 [4] | 1600 mg ibuprofen daily, 25 mg prednisolone PO daily (5 days) | Spine | The patient responded to 5-days steroids and NSAIDs. The early recognition and treatment of reactive arthritis ensured a favourable outcome |
Cincinelli et al. 2021 [10] | 10 mg prednisolone PO daily | MCP | The patient responded to steroids. Like many other viral diseases, COVID-19 can play as a causative agent or as a trigger for inflammatory arthritis development in predisposed individuals |
Coath et al. 2020 [11] | 120 mg IM methylprednisolone daily, 75 mg diclofenac daily, | Spine, chest wall | There was a definite temporal relationship between COVID-19 infection and the onset of axial disease, in a timeframe that would typically be expected for reactive arthritis |
Danssaert et al. 2020 [13] | Dilaudid IM and PO, oxycodone PO, neurontin daily | Hand | It is possible that symptoms could have been unrelated to COVID-19, but the extensive workup in the hospital did not reveal another potential cause |
De Stefano et al. 2020 [14] | Elbow | A state of virus induced transient immunosuppression may predispose to reactive arthritis even in the absence of a genetic background | |
Di Carlo et al. 2021 [15] | 4 mg methylprednisolone daily | Ankle | COVID-19 was considered the infectious trigger of reactive arthritis diagnosed. This conclusion was also supported by the time interval of few weeks between reactive arthritis onset and COVID-19 |
Fragata et al. 2020 [19] | 1200 mg ibuprofen daily; 5 mg PO prednisolone (5 days) | PIP, DIP, MCP | Reactive viral arthritis might be a late complication of COVID-19 |
Gasparotto et al. 2022 [22] | 600 mg ibuprofen (30 days) | Knee, ankle | Molecular mimicry might be the basic immunological mechanism responsible for the onset of COVID-19-related arthritis based on the current knowledge of COVID-19 and on the known pathogenetic mechanism of viral-induced arthritis |
Ghauri et al. 2020 [41] | IA steroids, NSAIDs | Knee | Physicians should have a high index of suspicion while treating any post infectious COVID-19 patient who presents with joint pain or arthralgia |
Gibson et al. 2020 [23] | 20 mg prednisolone OS daily, NSAIDs | ankle, wrist, PIP, shoulder, elbow, knee | A self-limiting episode of inflammatory arthritis may occur following COVID-19 infection |
Hasbani et al. 2021 [17] | 1 g naproxen daily, 40 mg prednisolone daily; 1 g sulphasalazine daily | Sacroiliac, ankle, elbow, wrist | COVID-19 can induce reactive arthritis even in not-predisposed population |
Hønge et al. 2021 [26] | 1200 mg OS ibuprofen daily; 25 mg OS prednisolone daily (6 days) | Knee, ankle | The condition improved markedly after a few days of NSAIDs and prednisolone administration |
Jali et al. 2020 [30] | Celecoxib (2 weeks) | DIP, PIP | Rheumatologists should consider Reactive arthritis as a possible complication of COVID-19, after an appropriate differential diagnostic |
Kocyigit et al. 2021 [35] | 150 mg diclofenac daily (6 weeks) | Knee | Comprehensive clinical and laboratory investigations, synovial fluid analysis, and close follow-up of the patient are essential |
Liew et al. 2020 [37] | Etoricoxib, triamcinolone IA | Knee | The high CT value of his COVID-19 swab on admission indicated low copies of viral RNA, suggesting that the patient was late in the course of COVID-19 when he developed reactive arthritis |
Mukarram et al. 2021 [42] | 10 mg prednisone daily, etoricoxib, 20 mg leflunomide daily, 400 mg hydroxychloroquine daily | PIPs, MTPs, MCPs, wrist, ankle | There is not sufficient data to indicate that people develop autoimmune inflammatory arthritis after being affected by COVID-19. Therefore, this case series adds a substantial amount of evidence to this hypothesis |
Ono et al. 2020 [43] | NSAIDs, steroids IA | Ankle | reactive arthritis should be considered in patients with acute arthritis after COVID-19 |
Pal et al. 2022 [46] | NSAIDs, hydroxychloroquine, methotrexate, steroids | Knee, ankle, wrists, MTPs, MCPs, shoulder, hip, spine | Axial symptoms and enthesitis were often coexistent. Treatment with NSAIDs and intra-articular steroids was effective. Whether COVID-19 was the definitive aetiology of the arthritis is yet to be proven |
Parisi et al. 2020 [49] | 1200 mg ibuprofen daily | Ankle | First case of arthritis in a COVID-19 patient in Europe |
Saikali et al. 2021 [51] | TNF \(\alpha\) inhibitor, certolizumab | sacroiliac, spine, knee | The importance of autoimmune and autoinflammatory diseases being triggered by COVID-19 |
Saricaoglu et al. 2020 [53] | NSAIDs | MTP, PIP, DIP | reactive arthritis as complication of COVID‐19 will raise the awareness of the physicians |
Schenker et al. 2020 [54] | Prednisolone | Knee, ankle, wrist | The timely relation, presence of HLA-B27 as well as the strong anti-COVID-19 IgG antibody response support the concept that COVID-19 induced an autoimmune response that led to reactive arthritis and vasculitis |
Shokraee et al. 2021 [57] | 200 mg indomethacin daily, 80 mg prednisolone IM | Hip, sacroiliac | COVID-19 can lead to autoimmune reactions, including reactive arthritis |
Sureja et al. 2021 [58] | NSAIDs, opioids | Knee, ankle, feet, wrist, MCP, PIP | The classical clinical picture, a preceding infection, absence of other autoantibodies, absence of autoimmunity in the family and response to NSAID, supported the diagnosis of reactive arthritis following COVID-19 |
Waller et al. 2020 [61] | MCP, wrist, shoulder, hip, knee | Classic post viral reactive arthritis has been seen following COVID-19. A registry to collect information on de novo autoimmune presentations would be highly informative | |
Yokogawa et al. 2020 [63] | Wrist, shoulder, knees | COVID-19 viraemia was absent in the case reported, which shared clinical features with reactive arthritis due to hepatitis B and C virus, parvovirus or alphavirus, such as chikungunya |