Chronic arthritis related to SARS-CoV-2 infection in a pediatric patient: A case report

• Main Authors: Luísa Rosa de Morais Palma Crivelenti, Marina Martins Nascimento Frazão, Marina Paiva de Melo Maia, Francisco Hugo Rodrigues Gomes, Luciana Martins de Carvalho
• Format: Article
• Language: English
• Published: Elsevier 2021-05-01
• Series: Brazilian Journal of Infectious Diseases
• Subjects: Chronic arthritis; SARS-CoV-2; pediatric inflammatory multisystem syndrome; COVID-19
• Online Access: http://www.sciencedirect.com/science/article/pii/S1413867021000544

Although the pattern of proinflammatory cytokines induced in COVID-2019 is similar to that of rheumatoid arthritis, the association of arthritis with SARS-CoV-2 infection is extremely rare and the symptoms are generally acute and self-limited. Herein we present the clinical case of a child who developed chronic arthritis after SARS-CoV-2 infection. An 11-year-old girl started with symptoms of multisystem inflammatory syndrome temporally associated with COVID-19 infection and subsequently developed chronic arthritis. After six weeks of arthritis, corticosteroids were started which resulted in clinical improvement after two weeks of use. Serology for SARS-CoV-2 was positive in the fifth week after symptom onset. Currently, the patient has no clinical complaints but continues to experience morning stiffness, high erythrocyte sedimentation rate, and synovial hypertrophy with no power Doppler signal on ultrasound. We alert to the possibility that SARS-CoV-2 may be a trigger of chronic arthritis.