AB0858 Clinical characteristics of patients with spondyloarthritis with COVID-19 in anamnesis in the Republic of Tatarstan

Abstract

BackgroundThe management of patients with spondyloarthritis (SpA) during the period of the novel coronavirus infection (NCI) pandemic is a significant problem due to insufficient evidence base.ObjectivesTo study the features of the course NCI and its influence on the course of SpA.MethodsFrom March 2020 to January 2022, 55 patients with SpA who underwent NCI (with a confirmed result of SarsCoV2 PCR and / or using X-ray computed tomography (CT) of the lungs): ankylosing spondylitis (AS) 37 people, with psoriatic arthritis (PsA) 18 people. Of these 32 (58.2%) were men, 23 (41.8%) - women, the average age of patients was 49 [37.5; 57.5] years. The duration of SpA at the time of NCI was 11 [7; 16] years. SpA activity before NCI was low in 15 (34.8%) patients, moderate in 25 (58.1%), and high in 3 (6.9%) patients. The results of clinical and laboratory examinations were evaluated during the NCI and after 1, 3, 6 months.ResultsSymptoms of NCI in patients with SpA were comparable in frequency and severity to the course of infection in the population. 47.3% had a mild course of NCI, and 52.7% of those observed had a moderate course, which is comparable with the general population data. Lung involvement was detected in 29 (52.7%) patients. The outcome of COVID-19 in all patients is recovery. Analysis of the course of SpA showed an increase in activity 1 and 3 months after NCI: BASDAI from baseline to COVID-19 4.3±1.57 to 4.9±1.7 points after 3 months, similar to ASDAS_CRP from 2.6±1, 2 to 3.7±0.2, BASFI from 3.0±1.9 to 3.8±1.8. A positive correlation was found between the severity of NCI and the BASFI index after 3 months (0.870). Analysis of the course of PsA showed an increase in activity 1 and 3 months after NCI: DAS28 from the baseline 2.78±0.98 to 4.15±1.16 points after 3 months. Of the total number of recoveries, 72.2% of patients showed an increase in activity due to clinical and laboratory parameters.78.1% of patients noted the presence of post-COVID symptoms after NCI, 56.3% had a combination of more than 3 different symptoms. Most often there was an increase/appearance of pain in the joints - in 78.1%: significant - in 61.8%, insignificant - in 16.3% of respondents. Strengthening/appearance of muscle pain and/or headache and/or dysautonomia occurred in 72.7%. This can be assessed as an exacerbation of the underlying disease, or, conversely, the appearance of arthralgia and myalgia could have an impact on the increase in AS and PsA activity indices. The second most frequent were a decrease in the quality of life (QOL) and working capacity in 69.0% of patients: significant in 36.3% of patients, insignificant in 32.7%.The appearance/intensification of shortness of breath and a decrease in exercise tolerance were noted by 60% of the respondents. Among them, 34.5% of patients with moderate severity, 25.4% - with mild NCI. Appearance/intensification of chest pain and/or palpitations was noted by 16.3% of patientsConclusionThe prevalence and course of the NCI in patients with SpA did not differ from that in the population. However, coronavirus infection has led to increased pain and an increase in AS activity, long-term persistence of post-COVID manifestations in the form of musculoskeletal pain and asthenic symptoms in the form of a decrease in the quality of life. At the same time, specific respiratory symptoms occurred in a third of patients and were not associated with the severity of the NCI.Disclosure of InterestsNone declared