{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:58:20Z","timestamp":1792789100408,"version":"4.5.0"},"reference-count":102,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"project 5x1000 year 2020\u2014income 2019 (progetto 5x1000 anno 2020\u2014redditi 2019)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>As the number of reports of post-acute COVID-19 musculoskeletal manifestations is rapidly rising, it is important to summarize the current available literature in order to shed light on this new and not fully understood phenomenon. Therefore, we conducted a systematic review to provide an updated picture of post-acute COVID-19 musculoskeletal manifestations of potential rheumatological interest, with a particular focus on joint pain, new onset of rheumatic musculoskeletal diseases and presence of autoantibodies related to inflammatory arthritis such as rheumatoid factor and anti-citrullinated protein antibodies. We included 54 original papers in our systematic review. The prevalence of arthralgia was found to range from 2% to 65% within a time frame varying from 4 weeks to 12 months after acute SARS-CoV-2 infection. Inflammatory arthritis was also reported with various clinical phenotypes such as symmetrical polyarthritis with RA-like pattern similar to other prototypical viral arthritis, polymyalgia-like symptoms, or acute monoarthritis and oligoarthritis of large joints resembling reactive arthritis. Moreover, high figures of post-COVID-19 patients fulfilling the classification criteria for fibromyalgia were found, ranging from 31% to 40%. Finally, the available literature about prevalence of rheumatoid factor and anti-citrullinated protein antibodies was largely inconsistent. In conclusion, manifestations of rheumatological interest such as joint pain, new-onset inflammatory arthritis and fibromyalgia are frequently reported after COVID-19, highlighting the potential role of SARS-CoV-2 as a trigger for the development of autoimmune conditions and rheumatic musculoskeletal diseases.<\/jats:p>","DOI":"10.3390\/diagnostics13111850","type":"journal-article","created":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T01:52:43Z","timestamp":1685065963000},"page":"1850","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Post-Acute COVID-19 Joint Pain and New Onset of Rheumatic Musculoskeletal Diseases: A Systematic Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9446-7351","authenticated-orcid":false,"given":"Jacopo","family":"Ciaffi","sequence":"first","affiliation":[{"name":"Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Vanni","sequence":"additional","affiliation":[{"name":"Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana","family":"Mancarella","sequence":"additional","affiliation":[{"name":"Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Brusi","sequence":"additional","affiliation":[{"name":"Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Lisi","sequence":"additional","affiliation":[{"name":"Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Pignatti","sequence":"additional","affiliation":[{"name":"Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Naldi","sequence":"additional","affiliation":[{"name":"Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5678-6506","authenticated-orcid":false,"given":"Elisa","family":"Assirelli","sequence":"additional","affiliation":[{"name":"Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3257-6293","authenticated-orcid":false,"given":"Simona","family":"Neri","sequence":"additional","affiliation":[{"name":"Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Reta","sequence":"additional","affiliation":[{"name":"UO Interaziendale Medicina Interna ad Indirizzo Reumatologico (SC) AUSL BO\u2014IRCCS AOU BO, 40133 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Faldini","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40126 Bologna, Italy"},{"name":"1st Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8194-8642","authenticated-orcid":false,"given":"Francesco","family":"Ursini","sequence":"additional","affiliation":[{"name":"Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"129","DOI":"10.7861\/clinmedicine.16-2-129","article-title":"Viral arthritis","volume":"16","author":"Marks","year":"2016","journal-title":"Clin. 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