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Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment.

Authors :
Shah S
Danda D
Kavadichanda C
Das S
Adarsh MB
Negi VS
Source :
Rheumatology international [Rheumatol Int] 2020 Oct; Vol. 40 (10), pp. 1539-1554. Date of Electronic Publication: 2020 Jul 14.
Publication Year :
2020

Abstract

The coronavirus disease-2019 (COVID-19) pandemic is likely to pose new challenges to the rheumatology community in the near and distant future. Some of the challenges, like the severity of COVID-19 among patients on immunosuppressive agents, are predictable and are being evaluated with great care and effort across the globe. A few others, such as atypical manifestations of COVID-19 mimicking rheumatic musculoskeletal diseases (RMDs) are being reported. Like in many other viral infections, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can potentially lead to an array of rheumatological and autoimmune manifestations by molecular mimicry (cross-reacting epitope between the virus and the host), bystander killing (virus-specific CD8 + T cells migrating to the target tissues and exerting cytotoxicity), epitope spreading, viral persistence (polyclonal activation due to the constant presence of viral antigens driving immune-mediated injury) and formation of neutrophil extracellular traps. In addition, the myriad of antiviral drugs presently being tried in the treatment of COVID-19 can result in several rheumatic musculoskeletal adverse effects. In this review, we have addressed the possible spectrum and mechanisms of various autoimmune and rheumatic musculoskeletal manifestations that can be precipitated by COVID-19 infection, its therapy, and the preventive strategies to contain the infection.

Subjects

Subjects :
Antibodies, Antinuclear immunology
Antibodies, Antiphospholipid immunology
Antiviral Agents adverse effects
Arthralgia etiology
Arthralgia immunology
Arthralgia physiopathology
Autoimmune Diseases etiology
Autoimmune Diseases immunology
Betacoronavirus
Blood Coagulation Disorders etiology
Blood Coagulation Disorders immunology
Blood Coagulation Disorders physiopathology
COVID-19
Coronavirus Infections complications
Coronavirus Infections drug therapy
Coronavirus Infections immunology
Cross Reactions immunology
Extracellular Traps immunology
Fibrin Fibrinogen Degradation Products
Guillain-Barre Syndrome etiology
Guillain-Barre Syndrome immunology
Guillain-Barre Syndrome physiopathology
Humans
Lupus Coagulation Inhibitor immunology
Molecular Mimicry
Mucocutaneous Lymph Node Syndrome etiology
Mucocutaneous Lymph Node Syndrome immunology
Mucocutaneous Lymph Node Syndrome physiopathology
Muscle Weakness etiology
Muscle Weakness immunology
Muscle Weakness physiopathology
Musculoskeletal Diseases etiology
Musculoskeletal Diseases immunology
Myalgia etiology
Myalgia immunology
Myalgia physiopathology
Myocarditis etiology
Myocarditis immunology
Myocarditis physiopathology
Pandemics
Pneumonia, Viral complications
Pneumonia, Viral drug therapy
Pneumonia, Viral immunology
Rheumatic Diseases etiology
Rheumatic Diseases immunology
SARS-CoV-2
COVID-19 Drug Treatment
Autoimmune Diseases physiopathology
Coronavirus Infections physiopathology
Musculoskeletal Diseases physiopathology
Pneumonia, Viral physiopathology
Rheumatic Diseases physiopathology

Details

Language :
English
ISSN :
1437-160X
Volume :
40
Issue :
10
Database :
MEDLINE
Journal :
Rheumatology international
Publication Type :
Academic Journal
Accession number :
32666137
Full Text :
https://doi.org/10.1007/s00296-020-04639-9