Impact of COVID-19 on Ankylosing Spondylitis: A Clinical Perspective

The relationship between COVID-19 infection and the progression of ankylosing spondylitis?

Hello, doctor.
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 COVID-19 diagnosis has led 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.

Shao, 20~29 year old female. Ask Date: 2023/02/23

Dr. Zeng Guosen reply Internal Medicine

There have indeed been reports that COVID-19 infection can lead to instability in autoimmune diseases.
However, in most patients, this worsening condition tends to gradually resolve over time.
There is no need to worry; you can seek medical advice and assistance from a physician.
Thank you for your question.

Reply Date: 2023/02/23

More Info

The impact of COVID-19 on patients with Ankylosing Spondylitis (AS) is an area of growing interest and concern among healthcare professionals. As we navigate through the ongoing pandemic, it is essential to understand how viral infections, particularly COVID-19, can affect chronic inflammatory conditions like AS.

1) Research and Observations on Disease Flare-Ups: Current studies and clinical observations suggest that COVID-19 can indeed exacerbate symptoms in patients with Ankylosing Spondylitis. While some patients may not experience significant changes in their condition post-infection, there is evidence indicating that others may see a worsening of their symptoms. This exacerbation can manifest as increased pain, stiffness, and overall disease activity. The underlying mechanisms are not fully understood but may relate to the inflammatory response triggered by the virus. Inflammatory cytokines released during a COVID-19 infection could potentially interact with the immune pathways involved in AS, leading to a flare-up of symptoms.
From clinical practice, it has been noted that some patients with AS who contracted COVID-19 reported a temporary increase in their symptoms. However, it is important to highlight that these changes are often transient. Many patients eventually return to their baseline level of disease control as they recover from the viral infection.
2) Duration and Resolution of Symptoms: Regarding the duration of symptom exacerbation, it is observed that, similar to long COVID, the inflammatory response in AS patients may take time to resolve. However, most patients tend to experience gradual improvement over time. The timeline for recovery can vary significantly among individuals, influenced by factors such as the severity of the COVID-19 infection, the patient's overall health, and their treatment regimen for AS.
Patients with AS are often on immunosuppressive therapies, which can complicate the clinical picture. These medications may influence the immune response to COVID-19 and the subsequent recovery process. Therefore, it is crucial for patients to maintain regular follow-ups with their healthcare providers to monitor their condition and adjust treatments as necessary.

In conclusion, while there is evidence that COVID-19 can lead to exacerbations in patients with Ankylosing Spondylitis, these effects are generally temporary. Most patients can expect to see their symptoms improve over time, although the duration of this process can vary. Continuous monitoring and communication with healthcare providers are essential for managing both AS and any potential complications arising from COVID-19.
As we continue to learn more about the long-term effects of COVID-19, it is vital for patients with chronic conditions like AS to stay informed and proactive in their healthcare management. Regular check-ups, adherence to treatment plans, and open discussions about any new symptoms or concerns can help ensure the best possible outcomes during these challenging times.

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