Features of the clinical course of rheumatic diseases in patients who have had a new coronavirus infection


DOI: https://dx.doi.org/10.18565/therapy.2021.10.42-54

Mazurov V.I., Belyaeva I.B., Sarantseva L.E., Chudinov A.L., Bashkinov R.A., Trofimov Е.А., Gaydukova I.Z., Smulskaya О.А., Inamova O.V., Petrova M.S., Khokhlova Y.V., Vasilenko Е.А., Melnikov Е.S.

1) I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, Saint Petersburg; 2) Clinical Rheumatology Hospital No. 25, Saint Petersburg
Abstract. The COVID-19 pandemic poses a particular threat to patients with immunoinflammatory rheumatic diseases (IRD).
Aim of the study: to evaluate the effect of COVID-19 on the clinical course of some IRD.
Material and methods. The clinical course of IRD was analyzed in 324 patients who underwent new coronavirus infection (NCI) from March 2020 to February 2021 and were treated at Clinical Rheumatology Hospital No.25 (Saint Petersburg) for exacerbation of the underlying disease.
Results. The risk factors of severe COVID-19 course in IRD were: age older than 60 years, presence of comorbid conditions (CHD, CHF, COPD), use of glucocorticoids in dose more than 12,5 mg/day and erythrocyte sedimentation rate values ≥40 mm/h before development of NCI. The use of immunosuppressive therapy and biological therapy had no effect on the worsening of the course of the viral infection in patients with IRD. The development of postсovid syndrome (asthenia, dyspnea, weight loss, memory loss) was noted in 1/4 of the patients. Postcovid articular syndrome was characterized by the formation of arthritis associated with viral infection in 3,6% of patients, transformation of undifferentiated arthritis (UDA) into specific nosological forms in 49% (more often into early rheumatoid arthritis), and exacerbation of joint syndrome in 83,4% of patients with advanced stage rheumatoid arthritis. In patients with diffuse connective tissue disease, a significant increase in immunological activity due to antinuclear antibodies (maximum 1:163840) was noted. Along with the results of the study, the article presents clinical cases of the development of arthritis associated with a viral infection and death in systemic scleroderma and interstitial lung damage after COVID-19.
Conclusion. In the cohort of patients with IRD observed at Clinical Rheumatology Hospital No. 25 (Saint Petersburg), COVID-19 had moderate and severe course in half of patients, initiated the development of pneumonic complications in 68,6% of patients, arthritis associated with viral infection in 3,6%, UDA transformation into IRD in 49% and exacerbation of the main disease in the overwhelming number of patients. Patients with diffuse connective tissue disease with interstitial lung damage have a high risk of adverse outcome of NCI and require dynamic monitoring by primary care physicians.
Keywords: postcovid syndrome, undifferentiated arthritis, immunoinflammatory rheumatic diseases, new coronavirus infection
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About the Autors

Vadim I. Mazurov, MD, professor, academician of RAS, Honored worker of science of Russian Federation, Director of the Research Institute of Rheumatology of I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, head of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, head of autoimmune center of Clinical Rheumatology Hospital No. 25 (Saint Petersburg). Address: 191015, Saint Petersburg, 41 Kirochnaya Str. E-mail: maz.nwgmu@yandex.ru. ORCID: 0000-0002-0797-2051. SPIN-code: 6823-5482
Irina B. Belyaeva, MD, professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str. Tel.: +7 (921) 750-86-39. E-mail: belib@mail.ru. ORCID: 0000-0002-7981-6349. SPIN-code: 3136-9062
Lyubov E. Sarantseva, senior laboratory assistant of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, rheumatologist at Clinical Rheumatology Hospital No. 25 (Saint Petersburg). Address: 190068, Saint Petersburg, 30 Bolshaya Podyacheskaya Str. Tel.: +7 (911) 267-89-64. E-mail: dr.liubovs@gmail.com
Anton L. Chudinov, PhD, head of the Center of biologic therapies, Clinical Rheumatology Hospital No. 25 (Saint Petersburg). Address: 190068, Saint Petersburg, 30 Bolshaya Podyacheskaya Str. E-mail: anton-chudinov@mail.ru. ORCID: 0000-0002-7675-5683. SPIN-code: 5771-8320
Roman A. Bashkinov, postgraduate student at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, rheumatologist at Clinical Rheumatology Hospital No. 25 (Saint Petersburg). Address: 190068, Saint Petersburg, 30 Bolshaya Podyacheskaya Str. E-mail: bashkinov-roman@mail.ru. ORCIDID: 0000-0001-9344-1304. SPIN-code: 5169-5066
Evgeny A. Trofimov, PhD, Deputy Director of the Research Institute of Rheumatology of I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, associate professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str. E-mail: evgeniy.trofimov@szgmu.ru. SPIN-code: 4358-1663
Inna Z. Gaydukova, MD, Deputy Director of the Research Institute of Rheumatology of I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, head of the section on autoimmune diseases and immunodeficiency states of RSMSIM. Address: 191015, Saint Petersburg, 41 Kirochnaya Str. E-mail: ubp1976@list.ru. ORCID: 0000-0003-3500-7256. SPIN-code: 3083-7996
Olga A. Smulskaya, PhD, rheumatologist at Clinical Rheumatology Hospital No. 25 (Saint Petersburg). Address: 190068, Saint Petersburg, 30 Bolshaya Podyacheskaya Str. E-mail: olgasmul@yandex.ru
Oksana V. Inamova, PhD, Chief physician of Clinical Rheumatology Hospital No. 25 (Saint Petersburg), Deputy Director of the Research Institute of Rheumatology of I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, assistant at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia. Address: 190068, Saint Petersburg, 30 Bolshaya Podyacheskaya Str. E-mail: b25@zdrav.spb.ru. ORCID: 0000-0001-9126-3639. SPIN-code: 8841-5496
Marianna S. Petrova, PhD, Deputy Chief physician of Clinical Rheumatology Hospital No. 25 (Saint Petersburg), Head of the «City Clinical Center for Gout» of Saint Petersburg, associate professor of at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia. Address: 190068, Saint Petersburg, 30 Bolshaya Podyacheskaya Str. E-mail: podagra@bk.ru. ORCIDID: 0000-0001-5261-6614
Yulia V. Khokhlova, rheumatologist at Clinical Rheumatology Hospital No. 25 (Saint Petersburg). Address: 190068, Saint Petersburg, 30 Bolshaya Podyacheskaya Str. E-mail: julia-khokhlova@mail.ru
Elizaveta A. Vasilenko, PhD, assistant at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, rheumatologist at Clinical Rheumatology Hospital No. 25 (Saint Petersburg). Address: 191015, Saint Petersburg, 41 Kirochnaya Str. E-mail: elisaavas@gmail.com. ORCID: 0000-0003-2153-5429. SPIN-код: 8065-5025.
Evgeny S. Melnikov, postgraduate student at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia, rheumatologist at Clinical Rheumatology Hospital No. 25 (Saint Petersburg). Address: 190068, Saint Petersburg, 30 Bolshaya Podyacheskaya Str. E-mail: melnikovzhenya@mail.ru. ORCID: 0000-0002-8521-6542


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