While researchers have studied how inflammatory rheumatic diseases and the use of immunosuppressants affect the early stage of COVID-19, fewer studies have focused on long-term effects of the virus.
For that reason, researchers in Amsterdam aimed to investigate the likelihood for people with inflammatory rheumatic diseases to develop post-COVID condition (commonly known as long COVID). In addition, researchers compared the symptoms observed in these patients with those observed in healthy individuals, both with and without a history of COVID. Their findings, recently published in The Lancet Rheumatology, revealed that people with inflammatory rheumatic diseases were more likely to report symptoms consistent with long COVID than people in both healthy control groups.
This substudy used data from an ongoing study in the Netherlands. Adults with inflammatory rheumatic diseases were invited to participate between April 2020 and March 2021. They were asked (but not obligated) to find a control participant of the same age and sex without an inflammatory rheumatic disease. Participants provided demographic and clinical information, including data on COVID infections, through online questionnaires. Then, on March 10, 2022, all participants received a questionnaire about persistent symptoms during the first two years of the COVID-19 pandemic, regardless of their infection history. Researchers also monitored a subset of participants with confirmed COVID infection to study their post-infection outcomes. Post-COVID condition was defined as persistent symptoms lasting at least 8 weeks, starting within 3 months of confirmed infection, and not attributable to another cause, following WHO guidelines.
A total of 1974 patients with inflammatory rheumatic disease and 733 healthy controls participated. 468 (24%) patients with inflammatory rheumatic disease and 218 (30%) healthy controls had a recent SARS-CoV-2 omicron infection. Of those, 365 (78%) patients with inflammatory rheumatic disease and 172 (79%) healthy controls completed follow-up questionnaires on COVID-19 outcomes. Recovery time from post-COVID condition was similar for patients and controls. More patients (21%) than controls (13%) fulfilled the criteria for post-COVID condition.
However, among those without a history of COVID, patients with inflammatory diseases were more likely to report persistent symptoms consistent with post-COVID condition than healthy individuals. These results suggest that perhaps the reason patients with inflammatory rheumatic diseases met the criteria for long COVID is that symptoms of rheumatic diseases (e.g., fatigue and loss of fitness) are similar to that of long COVID.
Therefore, the study concludes, it is important for doctors to acknowledge that the current criteria for diagnosing long COVID may not adequately capture the experiences of patients with inflammatory rheumatic disease and to approach discussions about the long-term effects of COVID-19 with a nuanced perspective.
- Post-COVID condition in patients with inflammatory rheumatic diseases: a prospective cohort study in the Netherlands
- Long COVID in inflammatory rheumatic diseases—what’s in a name?