Does COVID-19 Worsen Conditions in Patients with Ankylosing Spondylitis?

Q: Does COVID-19 Worsen Conditions in Patients with Ankylosing Spondylitis?

Hello, thank you for your question. <br>Here are my responses： <br>1) Are there any relevant studies confirming that COVID-19 infection can worsen the condition of patients with ankylosing spondylitis who previously had their disease under control? Or have you observed in your cl

Will a COVID-19 infection worsen the condition of patients with ankylosing spondylitis who previously had their disease under control?

Hello, Doctor Gao.
I would like to ask: 1) Are there any relevant studies that confirm that a diagnosis of COVID-19 can worsen the condition of patients with ankylosing spondylitis who previously had their disease under control? Or, based on your observations from patients in your clinic, have you noticed that a COVID-19 diagnosis leads to a deterioration of their previously controlled condition? 2) If such deterioration occurs, will it, like long COVID, gradually resolve over time? Thank you, Doctor.

Yang, 20~29 year old female. Ask Date: 2023/02/21

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
Here are my responses:
1) Are there any relevant studies confirming that COVID-19 infection can worsen the condition of patients with ankylosing spondylitis who previously had their disease under control? Or have you observed in your clinic that patients with previously controlled conditions experience worsening after a COVID-19 diagnosis? --> My patients, even after contracting COVID-19, did not show significant worsening of their condition; however, there are indeed studies that confirm that ankylosing spondylitis patients may experience more severe symptoms after infection.
Nonetheless, these manifestations are usually temporary, and the condition is expected to gradually improve and regain control over time.
2) If such worsening occurs, will it, like long COVID, gradually resolve over time? --> As mentioned, most patients will gradually improve in the future.

From the Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, we care about you.

Reply Date: 2023/02/21

More Info

The relationship between COVID-19 and pre-existing conditions, such as Ankylosing Spondylitis (AS), is a topic of ongoing research. Here’s a comprehensive overview based on current medical knowledge and studies.

1. Impact of COVID-19 on Ankylosing Spondylitis:
There is limited but growing evidence regarding the effects of COVID-19 on patients with Ankylosing Spondylitis. Some studies suggest that individuals with autoimmune conditions, including AS, may experience exacerbations of their underlying disease after contracting COVID-19. This could be due to several factors, including the inflammatory response triggered by the virus, which might lead to increased disease activity in patients who previously had their condition well-controlled.
For instance, a study published in the journal *Rheumatology* indicated that patients with rheumatic diseases, including AS, reported a worsening of their symptoms post-COVID-19 infection. This could manifest as increased pain, stiffness, and fatigue, which are common symptoms of AS. However, the extent of this exacerbation can vary significantly among individuals. Some patients may experience a temporary increase in symptoms, while others may see a more prolonged impact.

2. Long COVID and Its Relation to Ankylosing Spondylitis:
Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), refers to a range of symptoms that persist for weeks or months after the initial infection has resolved. For patients with AS, there is a possibility that the inflammatory processes associated with COVID-19 could lead to prolonged symptoms, including those related to their underlying condition.
The duration and nature of these symptoms can vary. Some patients report that their symptoms gradually improve over time, while others may experience persistent issues that require ongoing management. The relationship between long COVID and autoimmune diseases is complex and still being studied. It is essential for patients to maintain regular follow-ups with their healthcare providers to monitor their condition and adjust treatment plans as necessary.

3. Management and Monitoring:
For patients with Ankylosing Spondylitis who contract COVID-19, it is crucial to have a comprehensive management plan in place. This includes monitoring disease activity, adjusting medications if necessary, and addressing any new symptoms that arise. Patients should be encouraged to communicate openly with their healthcare providers about any changes in their condition, especially after a COVID-19 infection.

Additionally, maintaining a healthy lifestyle, including regular exercise, a balanced diet, and stress management techniques, can help mitigate some of the adverse effects of both COVID-19 and AS. It is also advisable for patients to stay updated on vaccinations and other preventive measures against COVID-19, as these can significantly reduce the risk of severe illness.

In conclusion, while there is evidence suggesting that COVID-19 may exacerbate conditions like Ankylosing Spondylitis, the degree of impact varies among individuals. Continuous research is necessary to fully understand these interactions. Patients should remain vigilant and proactive in managing their health, especially in the context of COVID-19. Regular consultations with healthcare providers can help ensure that any changes in their condition are addressed promptly and effectively.

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