CLINICAL AND IMMUNOLOGICAL RELATIONSHIP BETWEEN COVID-19 AND RHEUMATOID ARTHRITIS

Аннотация

Rheumatoid arthritis is the most common inflammatory disease of the joints, characterized by erosive symmetrical polyarthritis in combination with systemic immune-inflammatory damage to internal organs. One of the most severe and widespread inflammatory diseases of the joints. Rheumatoid arthritis is a common disease, occurring in all countries in approximately 1% of the total population. New data have shown that respiratory viral infections may increase the risk of autoimmune inflammatory arthritis, such as rheumatoid arthritis. In addition, infections may worsen the disease in patients with inflammatory arthritis. Key words: COVID-19, immune-inflammatory rheumatic diseases, diagnostics, cytokines. Relevance: The incidence of the new coronavirus COVID-19 is considered by the world community as an emergency of international concern. Along with its enormous social significance, the COVID-19 pandemic has highlighted a number of fundamentally new clinical and fundamental problems in the immunopathology of human diseases. This problem is extremely relevant for patients suffering from immune-mediated inflammatory rheumatic diseases, due to their higher susceptibility to infectious complications [1]. The coronavirus disease 2019 (COVID-19) pandemic, etiologically associated with the SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) virus, has drawn attention to new clinical and fundamental problems in the immunopathology of human diseases associated with virus-induced autoimmunity and autoinflammation [2]. Currently, the infection caused by the new coronavirus – COVID-19, is considered by the world community as a global emergency. Rheumatologists are particularly concerned about this problem, since patients with immune-inflammatory rheumatic diseases (IIRD) have an increased risk of developing infectious diseases and are treated with drugs that have an immunosuppressive effect [3,8,9]. The early period of rheumatoid arthritis plays a decisive role in the development and progression of immune complex inflammation. At the same time, early diagnosis of RA allows for adequate treatment and a more significant clinical effect, as well as improving the prognosis of this disease [5,10,12]. Early diagnosis, regular monitoring of disease activity, and a treat-to-target strategy are recommended for both CPA-positive and -negative RA, but the efficacy of individual drugs in these https://scientific-jl.com/new 66 11 Volume–77_Issue-2_May-2025 JOURNAL OF NEW CENTURY INNOVATIONS subtypes may vary significantly. The development of autoimmune and rheumatic diseases in patients who have had COVID-19 is a pressing public health issue. COVID- 19 may unmask previously undiagnosed rheumatic conditions or trigger the disease denovo [6,10]. As noted earlier, patients with IVR3 have a higher risk of developing infections than the general population, which reflects the immunopathological disorders inherent in these diseases. In addition, the risk of infection is clearly associated with the degree of activity of the process [7,10,11]. Materials and methods of the study: The study included 120 patients with rheumatoid arthritis (meeting the criteria of EULAR/ACR, 2010). During the study, patients were divided into 2 groups: the main group - 60 patients with rheumatoid arthritis who had COVID-19, and the control group - 60 patients with rheumatoid arthritis who had not had COVID-19. Patients were studied in comparison based on the analysis of clinical, laboratory and instrumental parameters. Results of the study: At the time of the study, the average age of patients was 41.7±11.7 years, the average duration of the disease was 10.7±5.8 years. According to the anamnesis, 75 (62.5%) patients with RA had a gradual onset of the disease, and 35 (29%) had an acute onset. The course of the disease in the main group (RA patients who had COVID-19) differed in a number of aspects. According to current scientific data, viral infections can increase the severity of inflammation or aggravate an existing immune imbalance in autoimmune diseases, including RA. According to our observations: morning sickness was observed in 89% of patients in group I and in 82% of patients in the control group. The duration of morning stiffness averaged 89±19.3 minutes in group I and 70±14.8 minutes in group II. Thus, it was found that both the percentage of morning stiffness and its duration were higher in RA patients who had COVID-19. Participants in Group I experienced frequent fatigue, general malaise, and even sleep disturbances or constant weakness, which are symptoms of “post-Covid syndrome”. In Group II, these symptoms were observed comparatively less frequently. Patients who recovered from COVID-19 showed elevated levels of almost all indicators. This is explained by the fact that in RA, the existing autoimmune process is further aggravated by a viral infection, triggering a cascade of inflammatory reactions. Thus, previously unobserved or rare complicatio