Rheumatological symptoms after COVID-19 pneumonia presenting as long COVID: What we need to know?

Abstract

COVID-19 pandemic is in verge of over and evolved over last three years in different waves across the globe with various genetic mutants or strains. As of now, many COVID-19 recovered patients are lingering with residual symptoms of illness irrespective of disease severity called as long COVID. Nonspecific or vague and organic or topographical organ specific symptoms are very well described in literature in COVID-19 survived cases. Rheumatological symptoms are most documented in published data as sequel after COVID-19 illness. Clinical presentations of rheumatological symptoms are joint or musculoskeletal pain, chronic fatigue with minimal exertion and weakness or impaired quality of life. Pathophysiology involving in rheumatological manifestations would be persistent or dysregulated inflammatory response, immune activation or thrombogenic pathway abnormality after acute COVID-19 illness. Diagnosis is little difficult and needs prompt workup to rule out underlying rheumatological illness. Inflammatory markers and autoantibody analysis has documented role in work up and confirming the diagnosis in majority of cases. Management of these cases is still evolving and showed response to lifestyle modification, physiotherapy, and short course of steroids and multivitamins in various published studies.