Постковидный синдром у пациентов с ревматическими заболеваниями

Abstract

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.