J Korean Med Sci.  2022 Dec;37(50):e355. 10.3346/jkms.2022.37.e355.

Knowledge and Perceptions of Reactive Arthritis Diagnosis and Management Among Healthcare Workers During the COVID-19 Pandemic: Online Survey

• Bekaryssova D
• Joshi M
• Gupta L
• Yessirkepov M
• Gupta P
• Zimba O
• Gasparyan AY
• Ahmed S
• Kitas GD
• Agarwal V

• KMID: 2537053
• DOI: http://doi.org/10.3346/jkms.2022.37.e355

Abstract

Background
Reactive arthritis (ReA) is an often neglected disease that received some attention during the coronavirus disease 2019 (COVID-19) pandemic. There is some evidence that infection with severe acute respiratory syndrome coronavirus 2 can lead to “reactive” arthritis. However, this does not follow the classical definition of ReA that limits the organisms leading to this condition. Also, there is no recommendation by any international society on the management of ReA during the current pandemic. Thus, a survey was conducted to gather information about how modern clinicians across the world approach ReA.
Methods
An e-survey was carried out based on convenient sampling via social media platforms. Twenty questions were validated on the pathogenesis, clinical presentation, and management of ReA. These also included information on post-COVID-19 arthritis. Duplicate entries were prevented and standard guidelines were followed for reporting internet-based surveys.
Results
There were 193 respondents from 24 countries. Around one-fifth knew the classical definition of ReA. Nearly half considered the triad of conjunctivitis, urethritis and asymmetric oligoarthritis a “must” for diagnosis of ReA. Other common manifestations reported include enthesitis, dermatitis, dactylitis, uveitis, and oral or genital ulcers. Threefourths opined that no test was specific for ReA. Drugs for ReA were non-steroidal antiinflammatory drugs, intra-articular injections, and conventional disease-modifying agents with less than 10% supporting biological use.
Conclusion
The survey brought out the gap in existing concepts of ReA. The current definition needs to be updated. There is an unmet need for consensus recommendations for the management of ReA, including the use of biologicals.

Keyword

Reactive Arthritis; Post-Infectious Arthritis; COVID-19; Definition; Treatment; Surveys and Questionnaires

Figure

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  Fig. 1 Time period between contracting infection and presenting with ReA.ReA = reactive arthritis.

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  Fig. 2 Infections preceding ReA. Y axis depicts the number of respondents.ReA = reactive arthritis.

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  Fig. 3 Classic clinical presentation signs of ReA. Y axis depicts the number of respondents.ReA = reactive arthritis.

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  Fig. 4 Specific features of ReA. Y axis depicts the number of respondents.ReA = reactive arthritis.

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