key: cord-0788804-ogtuq6lv authors: Saricaoglu, Elif M.; Hasanoglu, Imran; Guner, Rahmet title: The first reactive arthritis case associated with COVID‐19 date: 2020-07-19 journal: J Med Virol DOI: 10.1002/jmv.26296 sha: ec87357c0449dc7d81fc8088dc12c48fd73beb68 doc_id: 788804 cord_uid: ogtuq6lv Novel coronavirus disease 2019 (COVID-19) arised from Wuhan Province in China in December 2019, has quickly become a global public health emergency. The first confirmed COVID-19 patient in Turkey was reported on 11th March 2020. A 73-year-old man with diabetes mellitus, hypertension and coronary heart disease presented to emergency department with a history of fever, weakness, and dry cough for one week. Nasopharyngeal and oropharyngeal swabs were positive for COVID-19. He was treated with ceftriaxone, hidroxychloroquine and azitromycin Severeal days after completion of COVID-19 treatment, asymetric oligoarticular arthritis in his lower extremities were developed. In the course of time, clinicians all over the world experienced several different forms of COVID-19. In this case, we report the first reactive artrhritis associated with COVID-19 infection. This article is protected by copyright. All rights reserved. New type pneumonia, later termed the novel coronavirus disease 2019 (COVID-19) arose from Wuhan Province in China in December 2019, has quickly become a global public health emergency. 1 The etiological agent was identified as a new type coronavirus, named as novel coronavirus (SARS-CoV-2). 2 Outbreak has rapidly spread all over the world 3 and the first confirmed COVID-19 patient in Turkey was reported on 11th March 2020. 2 A syndrome of dysregulated and systemic immune overactivation described as a cytokine storm or hyperinflammatory syndrome may develop during of the course COVID-19. 4 As a result, coagulation and inflammation can significantly affect disease progression. 4, 5 In this case, we report the first reactive arthritis associated with COVID-19 infection. To our knowledge, this is the first ReA case caused by COVID-19. ReA belongs to a group of diseases known as spondyloarthritis is a sterile joint inflammation triggered by a distant infection in susceptible hosts. 5, 6 The time required for the development of ReA after infection takes a few days to 4 weeks. 5 ReA is characterized with typically asymmetric monoarthritis or oligoarthritis of the lower extremities as seen in our patient. 5 Although classical ReA is associated with urogenital and gastrointestinal infections, nonclassical ReA can be triggered by most other infections. 6 Because of a typical pattern of clinical presentation of arthritis plus the evidence of COVID-19 infection in the preceding 2 weeks; the patient was diagnosed with ReA caused by COVID-19. Abbreviations: ACE2, angiotensin-converting enzyme-2; anti-CCP, antibodies to cyclic citrullinated peptide; COVID-19, novel coronavirus disease 2019; NSAID, nonsteroidal anti-inflammatory drug; ReA, reactive arthritis; RF, Rheumatoid factor; SARS-CoV-2, novel coronavirus. The first infant case of COVID-19 acquired from a secondary transmission in Vietnam Crushing the curve, the role of national and international institutions and policy makers in COVID-19 pandemic The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The experience of clinical immunologists from China Immunomodulation in COVID-19 Reactive arthritis Pathogenesis of ankylosing spondylitis and reactive arthritis Prevalence of gastrointestinal symptoms and fecal viral shedding in patients with coronavirus disease 2019 Angiotensin-converting enzyme 2: SARS-CoV-2 receptor and regulator of the renin-angiotensin system