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COVID-19-Related Arthritis: Difference between Viral Arthritis and Reactive Arthritis

Shigeto Kobayashi, Issei Kida, Yoshinori Taniguchi, Kuris Tada, Naoto Tamura

Sterile arthritis has been reported in patients with Coronavirus Disease (COVID-19). However, some patients had been inappropriately diagnosed with ‘Reactive Arthritis (ReA)’ instead of ‘viral arthritis’. ReA is a form of sterile arthritis that occur secondary to an extraarticular infection in genetically predisposed individuals. The extra articular infection is typically a bacterial infection of the gastrointestinal or genitourinary tract. The definition, diagnostic criteria, and list of causative bacteria were proposed at the Fourth international workshop on reactive arthritis held in 1999. The clinical features of patients with COVID-19-related arthritis do not only fit with the definition and diagnostic criteria. The clinical course of extraarticular infection and subsequent self-limiting arthritis is sometimes similar for both viral arthritis and ReA. However, the duration of arthritis is generally much shorter in viral arthritis than in ReA. Therefore, it should be necessary to understand that COVID-19-related arthritis falls into a distinct category of ‘viral arthritis’ that is different from ReA.