{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:04:11Z","timestamp":1773792251929,"version":"3.50.1"},"reference-count":46,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T00:00:00Z","timestamp":1663027200000},"content-version":"unspecified","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"European Alliance of Associations for Rheumatology","award":["NA"],"award-info":[{"award-number":["NA"]}]},{"name":"National Institute for Health Research (NIHR), University College London Hospitals (UCLH), Biomedical Research Centre","award":["NA"],"award-info":[{"award-number":["NA"]}]},{"name":"Turkish Society for Rheumatology","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2022,8,20]]},"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:p>The current COVID-19 pandemic raises several clinical challenges. Cases of COVID-19-associated arthritis have been reported, and inconsistently described as either COVID-19 viral arthritis or COVID-19 reactive arthritis. We aimed to review all the reported cases of \u2018COVID-19-associated arthritis\u2019, which we propose, is a better term to define the entire spectrum of new-onset arthritis believed to be associated with SARS-CoV-2 infection. We performed a systematic literature review using MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews to search for articles published up to 13 December 2021. We included cohort studies, case series and case reports describing patients diagnosed with COVID-19 reactive or viral arthritis by a physician, irrespective of fulfilment of classification criteria. To identify relevant studies, medical subject headings and keywords related to \u2018COVID-19\/SARS-CoV-2 infection\u2019 and \u2018reactive arthritis\u2019 were used. Our search retrieved 419 articles, of which 31 were included in the review. A total of 33 cases were reported in these 31 articles, the majority being adults (28\/33=85%) with peripheral joint involvement (26\/33=79%). Most of the patients responded well to treatment and the disease was self-limiting. These 33 case reports describe a possible causal relationship between exposure to SARS-CoV-2 and the onset of arthritis. However, since these cases were reported during a pandemic, other aetiologies cannot be fully excluded. The exact mechanism through which SARS-CoV-2 might trigger arthritis is not fully understood and robust epidemiological data to support a causal relationship are still lacking.<\/jats:p>","DOI":"10.1136\/rmdopen-2021-002026","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T11:43:20Z","timestamp":1663069400000},"page":"e002026","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["COVID-19-associated arthritis: an emerging new entity?"],"prefix":"10.1136","volume":"8","author":[{"given":"Bayram","family":"Farisogullari","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4026-8357","authenticated-orcid":false,"given":"Ana S","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Unidade Local de Sa\u00fade da Guarda EPE, Guarda, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8411-7972","authenticated-orcid":false,"given":"Pedro M","family":"Machado","sequence":"additional","affiliation":[{"name":"Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, UK"},{"name":"National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK"}]}],"member":"239","published-online":{"date-parts":[[2022,9,13]]},"reference":[{"key":"2025090313220609000_8.2.e002026.1","unstructured":"WHO coronavirus (COVID-19) Dashboard, 2022. Available: https:\/\/covid19.who.int\/ [Accessed 26 Feb 2022]."},{"key":"2025090313220609000_8.2.e002026.2","doi-asserted-by":"crossref","DOI":"10.1016\/j.berh.2020.101657","article-title":"Novel coronavirus disease-2019 (COVID-19) in people with rheumatic disease: epidemiology and outcomes","volume":"35","author":"Grainger","year":"2021","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"2025090313220609000_8.2.e002026.3","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-020-01479-w"},{"key":"2025090313220609000_8.2.e002026.4","doi-asserted-by":"publisher","DOI":"10.1111\/sji.12998"},{"key":"2025090313220609000_8.2.e002026.5","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-020-0451-z"},{"key":"2025090313220609000_8.2.e002026.6","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1007\/s00296-021-04879-3","article-title":"Expanding the spectrum of reactive arthritis (REA): classic REA and infection-related arthritis including poststreptococcal REA, Poncet's disease, and iBCG-induced REA","volume":"41","author":"Taniguchi","year":"2021","journal-title":"Rheumatol Int"},{"key":"2025090313220609000_8.2.e002026.7","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.idc.2017.01.002","article-title":"Reactive arthritis","volume":"31","author":"Schmitt","year":"2017","journal-title":"Infect Dis Clin North Am"},{"key":"2025090313220609000_8.2.e002026.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.006"},{"key":"2025090313220609000_8.2.e002026.9","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1002\/ccr3.3521","article-title":"Ten-year-old boy with atypical COVID-19 symptom presentation: a case report","volume":"9","author":"Houshmand","year":"2021","journal-title":"Clin Case Rep"},{"key":"2025090313220609000_8.2.e002026.10","doi-asserted-by":"crossref","DOI":"10.1186\/s12969-021-00555-9","article-title":"Post SARS-CoV-2 infection reactive arthritis: a brief report of two pediatric cases","volume":"19","author":"Sinaei","year":"2021","journal-title":"Pediatr Rheumatol Online J"},{"key":"2025090313220609000_8.2.e002026.11","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-218315"},{"key":"2025090313220609000_8.2.e002026.12","first-page":"423","article-title":"A case of human leukocyte antigen B27 positive reactive arthritis associated with severe acute respiratory syndrome coronavirus 2 infection","volume":"8","author":"Apaydin","year":"2021","journal-title":"North Clin Istanb"},{"key":"2025090313220609000_8.2.e002026.13","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1097\/RHU.0000000000001560","article-title":"A case of reactive arthritis secondary to coronavirus disease 2019 infection","volume":"26","author":"Liew","year":"2020","journal-title":"J Clin Rheumatol"},{"key":"2025090313220609000_8.2.e002026.14","doi-asserted-by":"crossref","first-page":"e518","DOI":"10.1016\/S2665-9913(20)30216-2","article-title":"Symmetric peripheral polyarthritis developed during SARS-CoV-2 infection","volume":"2","author":"Talarico","year":"2020","journal-title":"Lancet Rheumatol"},{"key":"2025090313220609000_8.2.e002026.15","doi-asserted-by":"crossref","DOI":"10.1007\/s12098-021-03992-2","article-title":"Post-COVID reactive arthritis","volume":"89","author":"Dutta","year":"2022","journal-title":"Indian J Pediatr"},{"key":"2025090313220609000_8.2.e002026.16","doi-asserted-by":"crossref","DOI":"10.1016\/j.jbspin.2020.06.009","article-title":"CoVid-19 related dactyitis","volume":"87","author":"Salvatierra","year":"2020","journal-title":"Joint Bone Spine"},{"key":"2025090313220609000_8.2.e002026.17","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000026089","article-title":"A case report of monoarthritis in a COVID-19 patient and literature review: simple actions for complex times","volume":"100","author":"Cincinelli","year":"2021","journal-title":"Medicine"},{"key":"2025090313220609000_8.2.e002026.18","doi-asserted-by":"crossref","DOI":"10.1093\/rap\/rkab001","article-title":"Reactive arthritis after SARS-CoV-2 infection","volume":"5","author":"Sureja","year":"2021","journal-title":"Rheumatol Adv Pract"},{"key":"2025090313220609000_8.2.e002026.19","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1002\/jmv.26296","article-title":"The first reactive arthritis case associated with COVID-19","volume":"93","author":"Saricaoglu","year":"2021","journal-title":"J Med Virol"},{"key":"2025090313220609000_8.2.e002026.20","doi-asserted-by":"crossref","first-page":"e232","DOI":"10.1093\/rheumatology\/keab009","article-title":"Axial presentation of reactive arthritis secondary to COVID-19 infection","volume":"60","author":"Coath","year":"2021","journal-title":"Rheumatology"},{"key":"2025090313220609000_8.2.e002026.21","article-title":"Transient monoarthritis and psoriatic skin lesions following COVID-19","author":"De Stefano","year":"2020","journal-title":"Ann Rheum Dis"},{"key":"2025090313220609000_8.2.e002026.22","first-page":"S25","article-title":"Can SARS-CoV-2 induce reactive arthritis?","volume":"39","author":"Di Carlo","year":"2021","journal-title":"Clinical and Experimental Rheumatology"},{"key":"2025090313220609000_8.2.e002026.23","doi-asserted-by":"crossref","first-page":"3357","DOI":"10.1007\/s10067-020-05550-1","article-title":"Post-COVID-19 arthritis: a case report and literature review","volume":"40","author":"Gasparotto","year":"2021","journal-title":"Clin Rheumatol"},{"key":"2025090313220609000_8.2.e002026.24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.24966\/CSMC-8801\/100101","article-title":"Post COVID-19 reactive arthritis: an emerging existence in the spectrum of musculoskeletal complications of SARS-CoV-2 infection","volume":"7","author":"","year":"2020","journal-title":"CSMC"},{"key":"2025090313220609000_8.2.e002026.25","article-title":"EP15\u2003A self-limiting symmetrical polyarthritis following COVID-19 infection","volume":"4","author":"Gibson","year":"2020","journal-title":"Rheumatol Adv Pract"},{"key":"2025090313220609000_8.2.e002026.26","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2020-241375","article-title":"Reactive arthritis after COVID-19","volume":"14","author":"H\u00f8nge","year":"2021","journal-title":"BMJ Case Rep"},{"key":"2025090313220609000_8.2.e002026.27","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2020-001350"},{"key":"2025090313220609000_8.2.e002026.28","article-title":"Reactive arthritis Post-SARS-CoV-2","volume":"13","author":"Ouedraogo","year":"2021","journal-title":"Cureus"},{"key":"2025090313220609000_8.2.e002026.29","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-218281"},{"key":"2025090313220609000_8.2.e002026.30","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1093\/rheumatology\/keaa689","article-title":"Reactive arthritis and cutaneous vasculitis after SARS-CoV-2 infection","volume":"60","author":"Schenker","year":"2021","journal-title":"Rheumatology"},{"key":"2025090313220609000_8.2.e002026.31","first-page":"17","article-title":"EP02 a rare case of reactive arthritis secondary to COVID-19","volume":"4i","author":"Sidhu","year":"2020","journal-title":"Rheumatol Adv Pract"},{"key":"2025090313220609000_8.2.e002026.32","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1007\/s00296-021-04998-x","article-title":"Reactive arthritis after COVID-19: a case-based review","volume":"41","author":"Kocyigit","year":"2021","journal-title":"Rheumatol Int"},{"key":"2025090313220609000_8.2.e002026.33","doi-asserted-by":"crossref","first-page":"e655","DOI":"10.1016\/S2665-9913(20)30348-9","article-title":"Viral arthritis and COVID-19","volume":"2","author":"Parisi","year":"2020","journal-title":"Lancet Rheumatol"},{"key":"2025090313220609000_8.2.e002026.34","first-page":"278","article-title":"Coronavirus disease 19 (COVID-19) complicated with post-viral arthritis","volume":"45","author":"Fragata","year":"2020","journal-title":"Acta Reumatol Port"},{"key":"2025090313220609000_8.2.e002026.35","article-title":"Reactive arthritis after COVID-19 infection","volume":"12","author":"Jali","year":"2020","journal-title":"Cureus"},{"key":"2025090313220609000_8.2.e002026.36","doi-asserted-by":"crossref","DOI":"10.1186\/s40794-021-00142-6","article-title":"Reactive arthritis in the right hip following COVID-19 infection: a case report","volume":"7","author":"Shokraee","year":"2021","journal-title":"Trop Dis Travel Med Vaccines"},{"key":"2025090313220609000_8.2.e002026.37","doi-asserted-by":"crossref","DOI":"10.3390\/v13081558","article-title":"Post-COVID-19 arthritis and sacroiliitis: natural history with longitudinal magnetic resonance imaging study in two cases and review of the literature","volume":"13","author":"Colatutto","year":"2021","journal-title":"Viruses"},{"key":"2025090313220609000_8.2.e002026.38","article-title":"Reactive arthritis in a 37-year-old female with SARS-CoV2 infection","volume":"12","author":"Danssaert","year":"2020","journal-title":"Cureus"},{"key":"2025090313220609000_8.2.e002026.39","article-title":"Extra-Articular manifestations in reactive arthritis due to COVID-19","volume":"13","author":"Santacruz","year":"2021","journal-title":"Cureus"},{"key":"2025090313220609000_8.2.e002026.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2004.05.008"},{"key":"2025090313220609000_8.2.e002026.41","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1093\/brain\/awaa433","article-title":"Epidemiological and cohort study finds no association between COVID-19 and Guillain-Barr\u00e9 syndrome","volume":"144","author":"Keddie","year":"2021","journal-title":"Brain"},{"key":"2025090313220609000_8.2.e002026.42","doi-asserted-by":"crossref","DOI":"10.3390\/v13040700","article-title":"Long-COVID and Post-COVID health complications: an up-to-date review on clinical conditions and their possible molecular mechanisms","volume":"13","author":"Silva Andrade","year":"2021","journal-title":"Viruses"},{"key":"2025090313220609000_8.2.e002026.43","doi-asserted-by":"publisher","DOI":"10.1080\/08916930500484708"},{"key":"2025090313220609000_8.2.e002026.44","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1002\/art.40359","article-title":"Gut microbiota perturbations in reactive arthritis and postinfectious spondyloarthritis","volume":"70","author":"Manasson","year":"2018","journal-title":"Arthritis Rheumatol"},{"key":"2025090313220609000_8.2.e002026.45","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-323020"},{"key":"2025090313220609000_8.2.e002026.46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.24966\/CSMC-8801\/100101","article-title":"Post COVID-19 reactive arthritis: an emerging existence in the spectrum of musculoskeletal complications of SARS-CoV-2 infection","volume":"7","author":"Mukarram","year":"2020","journal-title":"CSMC"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2021-002026","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T20:22:21Z","timestamp":1756930941000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2021-002026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":46,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,9,13]]},"published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1136\/rmdopen-2021-002026"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2021-002026","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9]]}}}