Long COVID & Systemic Autoimmune Rheumatic Diseases

November 1, 2022

Altered immunity and the use of immunosuppressive medications are factors which increase the risk of Long Covid in those suffering from systemic autoimmune rheumatic diseases (SARDs).

A recent study investigated prolonged COVID-19 symptoms in SARDs patients using data from the Global Rheumatology Alliance Vaccine Survey. Researchers identified 441 people who suffered from systemic autoimmune rheumatic diseases and COVID-19. Patients with Rheumatoid Arthritis, Systemic Lupus Erythematosus, Sjögren’s syndrome, Psoriatic Arthritis, and Antiphospholipid syndrome were included in the study. 82% of participants were on at least one disease-modifying antirheumatic drug (DMARD) at time of survey, including methotrexate, antimalarials and TNF-inhibitors.

Out of 441 people, 107 suffered prolonged symptom duration of 28 days or longer, and 42 experienced symptoms for more than 90 days. However, the overhaul median symptom duration was 15 days. In comparison, Covid symptoms are usually between 7 and 12 days in the general population.  

When analyzing the group that experienced 28 days or longer symptom duration, researchers did not observe statistical associations of SARD types with prolonged symptom duration. However, prolonged COVID-19 symptoms were associated with fibromyalgia in the group that experienced symptoms for 90 days or longer. 

Factors associated with prolonged COVID-19 symptoms included: severe COVID-19, hospitalization, number of co-morbidities, and osteoarthritis. Additionally, the onset of COVID-19 between January and July 2021 (compared to June 2020 or earlier) correlated with lower chances of prolonged COVID-19 symptom duration. Several factors can influence this observation. In  2021, patients had access to COVID-19 vaccines and treatments, e.g., monoclonal antibodies. Additionally, COVID-19 variants may have influenced the possibility of developing prolonged COVID-19 symptoms. It is possible that recall bias could also have affected results, as people who most recently had COVID-19 could more accurately report the duration of the symptoms. This could be an issue as the survey for this study relied on self-reporting.

Further studies are needed to define what treatments and disease management options are best for these patients.