Brahem Mouna, Jomaa Olfa, Arfa Sondess, Sarraj Rihab, Tekaya Rami, Berriche Olfa, Hachfi Haifa, Younes Mohamed
Rheumatology Department Taher Sfar University Hospital Mahdia Tunisia.
Endocrinology and Internal Medicine Department Taher Sfar University Hospital Mahdia Tunisia.
Clin Case Rep. 2023 May 15;11(5):e7334. doi: 10.1002/ccr3.7334. eCollection 2023 May.
Joint involvement in COVID-19 may occur at different stages of the disease and maybe represented by non-specific arthralgia or by acute arthritis. We report two cases of COVID-19 infection that were complicated by postviral reactive arthritis. Case 1: A 47-year-old male was presented 20 days after a COVID-19 infection with acute right knee arthritis. On biologic data, erythrocyte sedimentation rate and C-reactive protein were normal, and immunologic data were negative. A joint puncture was performed showing a turbid fluid. Testing for microcrystals was negative, as well as the synovial fluid culture. An infectious investigation was conducted, which was negative. The patient's complaints improved significantly, with analgesics and non-steroidal anti-inflammatory drugs (NSAID). Case 2: A 33-year-old female presented with acute left knee arthritis evolving for 48 h, free of fever, after a COVID-19 infection treated 15 days ago. On examination, besides knee arthritis, the osteoarticular examination was normal. A biological inflammatory syndrome was noted in laboratory tests. A yellow fluid with multiple PNN was detected in the joint fluid aspiration, with a negative culture. The patient was treated by analgesics and NSAID. The follow-up was highlighted by the arthritis resolution. Conclusion: Both of our cases are consistent with what has already been reported in the literature confirming the development of PostCOVID arthritis and strengthen the impending necessity of wider studies to identify rheumatologic manifestations in the short- and long-terms after surviving COVID-19.
新型冠状病毒肺炎（COVID-19）患者关节受累可能出现在疾病的不同阶段，表现为非特异性关节痛或急性关节炎。我们报告两例COVID-19感染并发病毒感染后反应性关节炎的病例。病例1：一名47岁男性在COVID-19感染20天后出现急性右膝关节炎。生物学检查数据显示，红细胞沉降率和C反应蛋白正常，免疫学检查数据为阴性。进行关节穿刺，抽出浑浊液体。微晶体检测及滑液培养均为阴性。进行感染方面的检查，结果为阴性。使用镇痛药和非甾体抗炎药（NSAID）后，患者的症状明显改善。病例2：一名33岁女性在15天前接受COVID-19治疗后，出现急性左膝关节炎，病程48小时，无发热。检查发现，除膝关节炎外，骨关节炎检查正常。实验室检查发现有生物学炎症综合征。关节液抽吸检查发现黄色液体，有多核中性粒细胞，培养结果为阴性。患者接受镇痛药和NSAID治疗。随访结果显示关节炎症状消退。结论：我们的两个病例均与文献报道一致，证实了COVID后关节炎的发生，并强化了开展更广泛研究以确定COVID-19康复后短期和长期风湿性表现的迫切必要性。
