Department of General Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong.
Department of Rheumatology, Southport and Ormskirk NHS Trust, Southport.
Monaldi Arch Chest Dis. 2022 Jun 8;93(1). doi: 10.4081/monaldi.2022.2195.
A 55-year-old man was admitted to a hospital in Northeast India with fever, cough and breathlessness and was diagnosed with severe COVID-19 pneumonia. He was a known case of seropositive, erosive rheumatoid arthritis (RA) and was taking disease-modifying anti-rheumatic drugs (DMARDs). The patient was treated with remdesivir, heparin and a short course of corticosteroids for COVID-19 pneumonia. With the improvement of COVID-19 pneumonia, the patient also noticed a marked improvement in his joint symptoms despite not taking any DMARDs for RA. The temporal relationship between the time of disappearance of all signs and symptoms of RA within a few days after COVID-19 pneumonia and maintenance of RA remission for over one year of follow up to date suggests that COVID-19 likely caused the remission of RA. This case highlights the need for larger studies to understand the COVID-19 effects on RA remission and their potential link if any. However, the evidence of worse outcome with COVID-19 in immunosuppression which is common in RA cannot be overlooked.
一位 55 岁男性因发热、咳嗽和呼吸困难而住进印度东北部的一家医院，被诊断患有严重的 COVID-19 肺炎。他是已知的血清阳性、侵蚀性类风湿关节炎（RA）患者，并正在服用疾病修饰抗风湿药物（DMARDs）。该患者因 COVID-19 肺炎接受了瑞德西韦、肝素和短期皮质类固醇治疗。随着 COVID-19 肺炎的改善，尽管未服用任何 DMARDs 治疗 RA，但患者的关节症状也明显改善。COVID-19 肺炎后几天内所有 RA 症状和体征消失与 RA 缓解持续超过一年的随访时间之间的时间关系表明，COVID-19 可能导致了 RA 的缓解。该病例强调需要进行更大规模的研究，以了解 COVID-19 对 RA 缓解的影响及其潜在联系（如果有的话）。然而，不能忽视 RA 中常见的免疫抑制对 COVID-19 不良后果的证据。
