Bilateral Gouty Arthritis Developing After Covid-19 Infection: A Case Report

Abstract

Introduction and Purpose: SARS-CoV-2 virus started in Wuhan, China in 2019 and caused the COVID-19 pandemic by affecting the whole world in a short time. Arthralgia is one of the symptoms that can be seen after Covid-19 infection and can be seen in 14.9% of the cases. However, data on rheumatic and inflammatory symptoms such as arthritis are scarce. Viral infections are known causes of acute arthralgia and arthritis. In the literature, there are many examples of reactive arthritis cases developing after Covid-19 infection. Gouty arthritis is the most common form of inflammatory arthritis. Acute gouty arthritis most often affects the first metatarsophalangeal joint in the foot. 
 Case Presentation: A 76-year-old male patient with chronic kidney disease, hypertension, and a history of coronary artery bypass using both leg saphenous 12 years ago was admitted to the emergency service with chest pain and increasing fatigue. Since the Covid-19 PCR result was positive, he was hospitalized for further examination and treatment. On the 14th day of hospitalization, the patient complained about pain around both big toes that started suddenly at night and worsened in the morning. In the patient's history, he stated that he had completely similar complaints several times with an interval of one year in the last 3 years and he recovered spontaneously in 10-15 days.
 Discussion and Conclusion: Although developing gouty arthritis etiology is not clear for our patient in this case, it is thought to be a secondary condition due to the development of the disease after Covid-19 infection. It was considered that our patient has bilateral gouty arthritis triggered primarily by COVID-19. Due to the limited number of studies, more case reports should be added to the literature on this subject.