City docs see spike in cases of rheumatoid arthritis, gout post-Covid

There has been a significant increase in cases of autoimmune disorders like rheumatoid arthritis among Covid patients in the post-pandemic period, city doctors said on Monday, ahead of World Arthritis Day.

World Arthritis Day is celebrated on October 12 every year to raise global awareness about arthritis, in which the body’s immune system attacks healthy cells in the body causing inflammation and resulting in painful swelling in parts of the body.

“The incidence of various kinds of auto-immune disorders like rheumatoid arthritis, lupus, gout and sarcoidosis, has seen an increase in the post-Covid period. Due to this, we are witnessing a substantial increase in the number of patients with arthritis in the last two-three years. Cases of rheumatoid arthritis have gone up by two to three times today compared to the pre-Covid period. There has been a significant uptick in cases of gout and Sarcoidosis too,” said Dr. Gaurav Seth, Senior Consultant -- Rheumatology at Sarvodaya Hospital, Faridabad.

This is because the SARS-CoV-2 virus, causing the Covid infection, has altered our immune system, the doctor said.

While many Covid patients continue to suffer joint and body pain, rheumatoid arthritis has seen significant rise among women between 30-50 years of age, he said.

A recent study led by South Korean researchers showed a significantly higher risk of multiple new-onset autoimmune and autoinflammatory connective-tissue disorders after Covid-19 infection. Covid patients, particularly those with severe infections had increased risk of onset of rheumatoid arthritis, adult-onset Still disease (a rare type of arthritis), Sjogren syndrome, ankylosing spondylitis, and sarcoidosis (growth of tiny collections of inflammatory cells in body), revealed the study, published in the JAMA Network Open.

The diseases’ link with Covid suggests the existence of a common pathway, which may involve excessive cytokine storms leading to prolonged autoimmune responses that trigger specific underlying pathophysiology of each disease.

“Covid was initially thought of as a disease of the pulmonary system in ordinary lungs but later on, it was discovered it compromises the immunity of the body that was one major factor that autoimmune diseases are on the rise in the post-Covid era,” said Dr Ashwani Maichand, Director, Department of Orthopaedics at the CK Birla Hospital (R), Delhi.

Dr Maichand also blamed the extensive use of steroids during Covid, which further caused a fall in the immunity of the patients, resulting in the rise of auto-immune diseases after Covid.

Dr. Seth said that even before the pandemic, cases of arthritis, especially osteoarthritis, were steadily going up in India due to increase in life expectancy and the fact that elderly people are now living much longer due to better healthcare access.

He noted that sedentary habits, especially during the pandemic time, have also led to a rise in the number of cases of gout. Rising consumption of junk food and processed foods is also responsible for rising cases of arthritis, as bad food habits can negatively alter the gut microbiome.

“The gut microbiome of a rheumatoid arthritis patient is very different from normal, healthy people. So a bad diet can play a big role in causing arthritis,” he said.

“Smoking is also a risk factor for rheumatoid arthritis. A good lifestyle can significantly delay the onset of arthritis,” he said.

However, the doctor said biological drugs have shown a ray of hope to patients.

“These have drastically reduced joint damage and joint deformities in rheumatoid arthritis patients, and complications like rheumatoid vasculitis (inflammation of blood vessels) that were common earlier have become rare. Biological drugs are becoming mainstream now, even though they are expensive compared to traditional drugs,” Dr. Seth said.