The new onset seropositive rheumatoid arthritis after COVID-19 infection: coincidental or related

Abstract views: 161 / PDF downloads: 62


  • Esra ÖZCAN Kastamonu University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Kastamonu, Turkey
  • Selahattin ÖZCAN Kastamonu University Faculty of Medicine, Department of Orthopaedics and Traumatology, Kastamonu, Turkey



Rheumatoid arthritis, COVID-19, Cytokine pathways


Coronavirus disease 2019 (COVID-19) is an infectious disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The relationship of COVID-19 with rheumatological disorders has been researched since 2019. Rheumatoid arthritis (RA) is one of the most common rheumatoid diseases. The relationship between RA and COVID-19 is particularly interesting due to common cytokines in etiopathogenesis. SARS-CoV-2 was involved in triggering RF-positive and ACPA-positive arthritis, which might be diagnosed as rheumatoid arthritis, but we cannot rule out the possibility that the onset of this arthritis could have been coincidental. We report the case who has the first flare of RA with a high titer of Rheumatoid Factor (RF) and Anti Citrullinated Protein Antibody (ACPA) after mild SARS-CoV- 2 infection.


Deane KD, Demoruelle MK, Kelmenson LB, et al. Genetic and environmental risk factors for rheumatoid arthritis. Best Pract Clin Rheumatol 2017; 31: 3-18.

Favalli EG, Ingegnoli F, De Lucia O, Cincinelli G, Cimaz R, Caporali R. COVID-19 infection and rheumatoid arthritis: Faraway, so close! Autoimm Rew 2020; 19: 102523.

Joo YB, Lim Y-H, Kim K-J, Park K-S, Park Y-J. Respiratory viral infections and the risk of rheumatoid arthritis. Artritis Res Ther 2019; 21: 1-8.

Dotan A, Muller S, Kanduc D, David P, Halpert G, Shoenfeld YJAR. The SARS-CoV-2 as an instrumental trigger of autoimmunity. Autoimm Rew 2021: 20: 102792

Guan W-J, Ni Z-Y, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708-20:

Huang X, Wei F, Hu L, Wen L, Chen K. Epidemiology and clinical characteristics of COVID-19. Arch Iran Med 2020; 23: 268-71.

Goyal P, Choi JJ, Pinheiro LC, et al. Clinical characteristics of COVID-19 in New York city. N Engl J Med 2020; 382: 2372-4.

Song X-J, Xiong D-L, Wang Z-Y, Yang D, Zhou L, Li R-C. Pain management during the COVID-19 pandemic in China: Lessons learned. Pain Med 2020; 21: 1319-23.

Joob B, Wiwanitkit V. Arthralgia as an initial presentation of COVID-19: observation. Rheumatol Int 2020; 40: 823.

Murat S, Karatekin BD, Icagasioglu A, Ulasoglu C, İçten S, Incealtin O. Clinical presentations of pain in patients with COVID-19 infection. Irish J Med Sci 2021; 190: 913-7.

Hyrich KL, Machado PM. Rheumatic disease and COVID-19: epidemiology and outcomes. Nat Rew Rheumatol 2021: 17: 71-2.

Ono K, Kishimoto M, Shimasaki T, et al. Reactive arthritis after COVID-19 infection. RMD Open 2020; 6: e001350.

Coath FL, Mackay J, Gaffney JK. Axial presentation of reactive arthritis secondary to COVID-19 infection. Rheumatology 2021. doi: 10.1093/ rheumatology/keab009.

Roongta R, Chattopadhyay A, Ghosh AJAotRD. Correspondence on ‘Onset of rheumatoid arthritis after COVID-19: coincidence or connected?’. Annals of Rheumatic Dis 2021; 80: 1096-8.

Perrot L, Hemon M, Busnel J-M, et al. First flare of ACPA-positive rheumatoid arthritis after SARS-CoV-2 infection. Lancet Rheumatol 2021; 3: e6-e8.

Baimukhamedov C, Barskova T, Matucci-Cerinic MJTLR. Arthritis after SARS-CoV-2 infection. Int J Rheumatic Dis 2021; 24: 1218.

Vlachoyiannopoulos PG, Magira E, Alexopoulos H, et al. Autoantibodies related to systemic autoimmune rheumatic diseases in severely ill patients with COVID-19. Annals of Reumatic Dis 2020; 79: 1661-3.

Derksen VF, Kissel T, Lamers-Karnebeek FB, et al. Onset of rheumatoid arthritis after COVID-19: coincidence or connected? Annals of Reumatic Dis 2021; 80: 1096-8.

Najafi S, Rajaei E, Moallemian R, Nokhostin F. The potential similarities of COVID-19 and autoimmune disease pathogenesis and therapeutic options: new insights approach. Clin Rheumatol 2020: 1-13.

Alam J, Jantan I, Bukhari SNAJB, Pharmacotherapy. Rheumatoid arthritis: recent advances on its etiology, role of cytokines and pharmacotherapy. Biomed Pharmacother 2017; 92: 615-33.

Schett G, Manger B, Simon D, Caporali RJNRR. COVID-19 revisiting inflammatory pathways of arthritis. Nat Rew Rheumatol 2020: 1-6.

Qin C, Ziwei MP, Tao SY, Ke PC, Shang M. M. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis 2020; ID: covidwho-7937.

Derksen V, van der Woude D. Response to: ‘Correspondence on ‘Onset of rheumatoid arthritis after COVID-19: coincidence or connected?’’ by Roongta et al. Annals of the Rheumatic Diseases 2021.

Tripathy A, Swain N, Gupta BJFV. The COVID-19 pandemic: an increased risk of rheumatoid arthritis. J Future Virol 2021; 16: 431-42.




How to Cite

ÖZCAN, E. ., & ÖZCAN, S. . (2022). The new onset seropositive rheumatoid arthritis after COVID-19 infection: coincidental or related. Kastamonu Medical Journal, 2(1), 24–26.

Most read articles by the same author(s)