Impact of long COVID on self-reported disease activity, disability, and quality of life in individuals with inflammatory arthritis.

Background: People with inflammatory arthritis are at risk for poor COVID-19 outcomes. Little is known about the impact of long COVID on disease activity, disability, and quality of life in this population.

Methods: We included participants with rheumatoid arthritis, psoriatic arthritis, juvenile idiopathic arthritis, or axial spondyloarthritis from RheumCARD, a prospective cohort study of people with rheumatic disease with and without prior COVID-19. Long COVID was defined as any symptom of acute COVID-19 for ≥90 days. Surveys include the Routine Assessment of Patient Index Data 3 (RAPID-3), modified health assessment questionnaire (MHAQ), short form-12 (SF-12), fatigue symptom inventory, and short form McGill Pain Questionnaire. We assessed the association of long COVID status with these outcomes.

Results: We analyzed n = 59 with long COVID, n = 165 without long COVID, and n = 59 without prior COVID-19. The most common long COVID symptoms were fatigue (37.3 %), altered smell/taste (27.1 % and 25.4 %), difficulty breathing (20.3 %), and headache (15.3 %). Those with vs. without long COVID had worse mHAQ (median 0.4 vs. 0.1, p < 0.001), RAPID-3 (4.0 vs. 2.3, p = 0.0005), and physical and mental health (SF-12: 37.7 vs. 47.2, p = 0.0003 and 45.3 vs. 53.0, p = 0.003, respectively). Fatigue and pain were worse in those with vs. without long COVID (p < 0.05 for comparisons). Similar trends were observed in those with long COVID vs. those without prior COVID-19.

Conclusion: Long COVID may result in worsened pain, fatigue, and quality of life in people with inflammatory arthritis. Patient-reported outcomes should be interpreted with caution in people with inflammatory arthritis because of the impact of long COVID.