Wallace Zachary S, Lin Miao, Srivatsan Shruthi, King Andrew, Wang Xiaosong, Venkat Rathnam, Kawano Yumeko, Negron Madison, Hang Buuthien, Schiff Abigail, Hanberg Jennifer, Kowalski Emily N, Johnson Colebrook, Vanni Kathleen M M, Williams Zachary, Qian Grace, Bolden Caleb, Mueller Kevin T, Bade Katarina J, Saavedra Alene A, Patel Naomi J, Sparks Jeffrey A
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA.
Semin Arthritis Rheum. 2025 Apr;71:152657. doi: 10.1016/j.semarthrit.2025.152657. Epub 2025 Feb 11.
People with inflammatory arthritis are at risk for poor COVID-19 outcomes. Little is known about the impact of long COVID on disease activity, disability, and quality of life in this population.
We included participants with rheumatoid arthritis, psoriatic arthritis, juvenile idiopathic arthritis, or axial spondyloarthritis from RheumCARD, a prospective cohort study of people with rheumatic disease with and without prior COVID-19. Long COVID was defined as any symptom of acute COVID-19 for ≥90 days. Surveys include the Routine Assessment of Patient Index Data 3 (RAPID-3), modified health assessment questionnaire (MHAQ), short form-12 (SF-12), fatigue symptom inventory, and short form McGill Pain Questionnaire. We assessed the association of long COVID status with these outcomes.
We analyzed n = 59 with long COVID, n = 165 without long COVID, and n = 59 without prior COVID-19. The most common long COVID symptoms were fatigue (37.3 %), altered smell/taste (27.1 % and 25.4 %), difficulty breathing (20.3 %), and headache (15.3 %). Those with vs. without long COVID had worse mHAQ (median 0.4 vs. 0.1, p < 0.001), RAPID-3 (4.0 vs. 2.3, p = 0.0005), and physical and mental health (SF-12: 37.7 vs. 47.2, p = 0.0003 and 45.3 vs. 53.0, p = 0.003, respectively). Fatigue and pain were worse in those with vs. without long COVID (p < 0.05 for comparisons). Similar trends were observed in those with long COVID vs. those without prior COVID-19.
Long COVID may result in worsened pain, fatigue, and quality of life in people with inflammatory arthritis. Patient-reported outcomes should be interpreted with caution in people with inflammatory arthritis because of the impact of long COVID.
炎症性关节炎患者感染新冠病毒后出现不良结局的风险较高。关于新冠后遗症对该人群疾病活动、残疾和生活质量的影响，目前知之甚少。
我们纳入了来自RheumCARD研究的类风湿关节炎、银屑病关节炎、幼年特发性关节炎或轴性脊柱关节炎患者，这是一项针对有或无新冠病毒感染史的风湿病患者的前瞻性队列研究。新冠后遗症定义为急性新冠病毒感染症状持续≥90天。调查包括患者指数数据3的常规评估（RAPID-3）、改良健康评估问卷（MHAQ）、简短健康调查问卷12（SF-12）、疲劳症状量表和简短麦吉尔疼痛问卷。我们评估了新冠后遗症状态与这些结局之间的关联。
我们分析了59例有新冠后遗症的患者、165例无新冠后遗症的患者以及59例无新冠病毒感染史的患者。最常见的新冠后遗症症状是疲劳（37.3%）、嗅觉/味觉改变（27.1%和25.4%）、呼吸困难（20.3%）和头痛（15.3%）。有新冠后遗症的患者与无新冠后遗症的患者相比，mHAQ评分更差（中位数0.4对0.1，p<0.001），RAPID-3评分更高（4.0对2.3，p=0.0005），身心健康状况更差（SF-12：身体维度37.7对47.2，p=0.0003；心理维度45.3对53.0，p=0.003）。有新冠后遗症的患者与无新冠后遗症的患者相比，疲劳和疼痛更严重（比较时p<0.05）。在有新冠后遗症的患者与无新冠病毒感染史的患者中也观察到了类似趋势。
新冠后遗症可能导致炎症性关节炎患者的疼痛、疲劳和生活质量恶化。由于新冠后遗症的影响，对于炎症性关节炎患者，患者报告的结局应谨慎解读。
