Pneumology - Case Reports
June 8, 2022
Vol. 93 No. 1 (2023)
https://doi.org/10.4081/monaldi.2022.2195

Complete persistent remission of rheumatoid arthritis after COVID-19 infection - A rare case and literature review

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Rheumatoid arthritis, COVID-19, remission, cytokine, immune dysregulation
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Authors

Bhupen Barman
https://orcid.org/0000-0002-5433-1310
Department of General Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, India.
Arvind Nune
arvind.nune@nhs.net
https://orcid.org/0000-0002-3849-614X
Department of Rheumatology, Southport and Ormskirk NHS Trust, Southport, United Kingdom.
Pranav Ish
https://orcid.org/0000-0003-1701-4970
Department of Pulmonary and Critical Care Medicine, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India.
Pranjal Phukan
Department of Radiology and Imaging, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, India.
Donboklang Lynser
Department of Radiology and Imaging, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, India.
Hem Raj Sapkota
Department of Rheumatology, The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom.

A 55-year-old man was admitted to a hospital in Northeast India with fever, cough and breathlessness and was diagnosed with severe COVID-19 pneumonia. He was a known case of seropositive, erosive rheumatoid arthritis (RA) and was taking disease-modifying anti-rheumatic drugs (DMARDs). The patient was treated with remdesivir, heparin and a short course of corticosteroids for COVID-19 pneumonia. With the improvement of COVID-19 pneumonia, the patient also noticed a marked improvement in his joint symptoms despite not taking any DMARDs for RA. The temporal relationship between the time of disappearance of all signs and symptoms of RA within a few days after COVID-19 pneumonia and maintenance of RA remission for over one year of follow up to date suggests that COVID-19 likely caused the remission of RA. This case highlights the need for larger studies to understand the COVID-19 effects on RA remission and their potential link if any. However, the evidence of worse outcome with COVID-19 in immunosuppression which is common in RA cannot be overlooked.

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“Complete Persistent Remission of Rheumatoid Arthritis After COVID-19 Infection - A Rare Case and Literature Review”. 2022. Monaldi Archives for Chest Disease 93 (1). https://doi.org/10.4081/monaldi.2022.2195.
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