A case report of monoarthritis in a COVID-19 patient and literature review: Simple actions for complex times. Issue 23 (11th June 2021)

• Record Type: Journal Article
• Authors: Cincinelli, Gilberto; Di Taranto, Raffaele; Orsini, Francesco; Rindone, Andrea; Murgo, Antonella; Caporali, Roberto
• Other Names: Saranathan. Maya section editor.
• Is Part Of: Medicine. Volume 100:Issue 23(2021)
• Publication Date: 2021-06-11
• Subjects: case report -- COVID-19 -- inflammatory arthritis -- psoriatic arthritis -- reactive arthritis; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000026089
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: COVID-19 presentation is multifaceted and up to 44% of patients affected by COVID-19 experience musculoskeletal complaints, mostly in the form of diffuse aspecific arthromyalgias. Nevertheless, only a few cases of arthritis following SARS-CoV2 infection are reported. Patient concerns: A 27-year-old man affected by nail psoriasis presented with monoarthritis 2 weeks after being diagnosed with COVID-19. Diagnoses: Diagnostic work-up and differential diagnosis were made difficult by patient isolation, absence of lab tests, and his visit via telemedicine, even though signs of first metacarpophalangeal joint involvement were clear. Interventions: Due to the inefficacy of acetaminophen and nonsteroidal anti-inflammatory drugs, the patient was prescribed oral steroids with a rapid benefit. Outcomes: The patient's response to oral steroid was prompt and maintained even after therapy tapering. Even so, a formal diagnosis was not possible due to a difficult diagnostic work-up and lack of a long-term follow-up. Lessons: Like many other viral diseases, SARS-CoV2 can play as a causative agent or as a trigger for inflammatory arthritis development in predisposed individuals.