Postcovid syndrome in patients with rheumatic diseases
DOI: 10.32364/2587-6821-2023-7-7-8
V.N. Mukhamadieva1,2, N.G. Shamsutdinova1,3, R.Z. Abdrakipov3, R.G. Mukhina2, D.I. Abdulganieva1,3
1Kazan State Medical University, Kazan, Russian Federation
2City Clinical Hospital No. 7, Kazan, Russian Federation
3Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, Kazan, Russian Federation
Aim: to study the incidence and duration of postcovid manifestations in patients with rheumatic diseases (RD), as well as the RD course patterns in the postcovid period.
Patients and Methods: 271 patients (mean age 56 [46; 65] years) were included in the study: with a diagnosis of rheumatoid arthritis (RA) — 186 (68.6%) patients, with ankylosing spondylitis (SpA) — 46 (16.9%), with psoriatic arthritis — 38 (14%) patients who had previously suffered COVID-19. The presence of postcovid syndrome (PCS) was determined 3, 6, 9 or 12 months after acute COVID-19. An in-depth medical check-up questionnaire for citizens who have experienced COVID-19 was used to identify the clinical symptoms of PCS. The article presents the results of the following scales: the Hospital Anxiety and Depression Scale (HADS) was used to identify and evaluate the severity of depression and anxiety, the Hamilton Depression Rating Scale (HAM-D) — to evaluate depression, the Asthenic State Scale (ASS) — to diagnose asthenic condition, and the Mini Mental State Examination (MMSE) — to study the severity of cognitive disorder. RD course progression was assessed 3, 6, 9 and 12 months after the experienced COVID-19.
Results: 75.3% of patients with RD had complaints characteristic of PCS, which could persist up to 12 months after undergoing COVID-19. 3 months after the COVID-19, during case follow-up and filling out the in-depth medical examination questionnaire, it was noticed that patients most commonly complained of increased joint pain (80.2% of patients), dyspnea, and reduced exercise tolerance (50.6% of patients). The second most common complaint was asthenovegetative manifestations. Given the analyze of RD activity in patients before, during and after the COVID-19 after 3, 6, 9 and 12 months, it was found that the maximum number of patients with RD exacerbation was 3 months after the COVID-19. It was also found that moderate and severe RD activity before COVID-19 had a direct effect on the incidence of increased joint pain 3 and 6 months after COVID-19. Patients with RD were significantly more likely to complain of reduced exercise tolerance, fatigue and muscle pain 3 and 6 months after COVID-19 versus patients with SpA. Anxiety-depressive disorders, cognitive impairments, and asthenic manifestations in the setting of PCS were registered more commonly in female patients for 6 months after undergoing COVID-19 than in male patients.
Conclusion: complaints characteristic of PCS were revealed in most of the patients with RD, persisting up to a year after the COVID-19: arthralgia and asthenic manifestations (fatigue, faintness) were most common in the respondents. Moderate and severe RD activity before the COVID-19 caused increased joint pain 3 and 6 months after the recovery from COVID-19. 3 months after the experienced COVID-19, patients with RD had more complaints characteristic of PCS and an increase RD activity itself. The gender patterns during the PCS course in patients with RD were also revealed.
Keywords: new coronavirus infection, rheumatic diseases, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, postcovid syndrome, in-depth health check-up, musculoskeletal manifestations, anxiety, depression, cognitive impairment, asthenia.
For citation: Mukhamadieva V.N., Shamsutdinova N.G., Abdrakipov R.Z., Mukhina R.G., Abdulganieva D.I. Postcovid syndrome in patients with rheumatic diseases. Russian Medical Inquiry. 2023;7(7):452–459 (in Russ.). DOI: 10.32364/2587-6821-2023-7-7-8.
About the authors:
Venera N. Mukhamadieva — postgraduate student of the Department of Hospital Therapy, Kazan State Medical University; 49, Butlerov str., Kazan, 420012, Russian Federation; rheumatologist of the City Clinical Hospital No. 7; 54, Marshal Chuikov str., Kazan, 420103, Russian Federation; ORCID iD 0000-0002-2731-104X.
Nailya G. Shamsutdinova — C. Sc. (Med.), Associate Professor of the Department of Hospital Therapy, Kazan State Medical University; 49, Butlerov str., Kazan, 420012, Russian Federation; rheumatologist of the Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan; 138, Orenburg Tract, Kazan, 420064, Russian Federation; ORCID iD 0000-0001-7320-0861.
Rifkat Z. Abdrakipov — rheumatologist of the Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan; 138, Orenburg Tract, Kazan, 420064, Russian Federation; ORCID iD 0000-0003-1140-3238.
Raviya G. Mukhina — rheumatologist of the City Clinical Hospital No. 7; 54, Marshal Chuikov str., Kazan, 420103, Russian Federation.
Diana I. Abdulganieva — Dr. Sc. (Med.), Professor, Head of the Department of Hospital Therapy, Kazan State Medical University; 49, Butlerov str., Kazan, 420012, Russian Federation; rheumatologist of the Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan; 138, Orenburg Tract, Kazan, 420064, Russian Federation; ORCID iD 0000-0001-7320-0861.
Contact information: Venera N. Mukhamadieva, e-mail: venera.mukhamadieva@yandex.ru.
Financial Disclosure: this work has been supported by the Grant of the President of the Russian Federation for leading scientific schools of the Russian Federation (topic "Development of health protection technologies for patients with immunoinflammatory disorders during the COVID-19 pandemic" (НШ-4321.2022.3).
There is no conflict of interest.
Received 30.03.2023.
Revised 24.04.2023.
Accepted 22.05.2023.
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