Researchers are investigating whether COVID-19 can cause rheumatoid arthritis (RA) as part of understanding the long-term effects of SARS-CoV-2 infection. Viral infections can trigger autoimmune responses, where the body’s immune system mistakenly attacks its own tissues.
Understanding Rheumatoid Arthritis
Rheumatoid arthritis is a chronic autoimmune disease primarily affecting the joints. It causes inflammation in the synovium, the lining of the joints, leading to pain, swelling, and stiffness. This inflammation commonly impacts joints in the fingers, hands, wrists, knees, ankles, and feet. RA often affects the same joints on both sides of the body.
Beyond joints, RA can also impact other organs and systems, including the skin, eyes, lungs, heart, and blood vessels. Symptoms often include morning stiffness lasting 30 minutes or longer, persistent fatigue, and sometimes a low-grade fever. While the exact cause of RA remains unknown, it involves genetic, hormonal, and environmental factors, with infections potentially acting as triggers in predisposed individuals.
The Interplay Between Viruses and Autoimmunity
Viruses can initiate or worsen autoimmune conditions through several mechanisms. One is molecular mimicry, where a viral protein’s structure closely resembles a human protein. The immune system, targeting the viral protein, can then mistakenly attack the similar host protein, leading to autoimmune damage.
Another mechanism is bystander activation. During an infection, inflammation can release immune signaling molecules called cytokines. This inflammatory environment can activate dormant self-reactive immune cells, causing them to attack healthy tissues. Persistent viral infections can also lead to continuous immune activation, contributing to autoimmune disease development.
COVID-19 and Rheumatoid Arthritis: Current Understanding
Research suggests a link between COVID-19 infection and rheumatoid arthritis development or exacerbation. Preliminary studies and anecdotal reports observe new-onset RA or RA flares following SARS-CoV-2 infection. Some individuals developed RA symptoms weeks to months after recovering from COVID-19. For example, one case described a 41-year-old woman diagnosed with seropositive RA one month after COVID-19, with no prior history.
The connection involves immune responses triggered by SARS-CoV-2. COVID-19 can lead to a hyperactive immune response, often called a “cytokine storm,” characterized by an excessive release of pro-inflammatory cytokines. This inflammatory profile, with elevated levels of cytokines like IL-1β, IL-6, and TNF-α, resembles inflammation seen in RA. This shared pathway suggests COVID-19 could trigger or worsen RA in susceptible individuals.
Molecular mimicry is also being investigated. Studies identify SARS-CoV-2 viral components sharing structural similarities with human proteins, potentially prompting autoantibody generation. New-onset autoantibodies, including those associated with rheumatic diseases, have been observed after COVID-19. While anti-citrullinated protein antibodies (ACPA), a specific RA marker, have been reported, their overall increase after COVID-19 infection is still under investigation.
Persistent inflammation and immune dysregulation in “Long COVID” further support COVID-19’s role in autoimmunity. The virus may disrupt immune system communication, causing immune cells to mistake the body’s own cells as a threat. Research is ongoing; while a link is suggested, the definitive causal relationship and precise frequency of RA development after COVID-19 are still under active investigation.
Navigating Symptoms and Seeking Medical Advice
If you have experienced COVID-19 and notice new or worsening joint symptoms, seek medical advice. Symptoms warranting attention include persistent joint pain, swelling, and stiffness, especially in the morning or after rest. Significant fatigue that does not improve with rest, and pain affecting the same joints on both sides of your body, are also important signs.
Consulting a healthcare professional, like your primary care physician, is the first step. They can evaluate symptoms, conduct tests, and, if needed, refer you to a rheumatologist, a specialist in autoimmune joint diseases. Early diagnosis of rheumatoid arthritis is important; timely treatment manages symptoms, slows disease progression, and reduces long-term joint damage. Self-diagnosis is not recommended; professional medical evaluation is necessary for proper assessment and care.