COVID-19-associated monoarthritis with early onset in a young male: a case report and review of the literature

Background : SARS-CoV-2, the virus responsible for the COVID-19 pandemic, primarily affects the respiratory system. The virus has also been associated with a range of extrapulmonary manifestations, potentially causing severe and life-threatening consequences. However, the reported cases of arthritis following SARS-CoV-2 infection are significantly fewer than those with pulmonary manifestations. In the current case report, we present a 27-year-old man who developed monoarthritis of the right ankle 5 days after a confirmed SARS-CoV-2 infection. Results : The symptoms, including edema, redness, impaired mobility, and pain unresponsive to painkillers and anti-inflammatories, persisted for about 6 weeks. Ten days after the first symptoms, the patient developed a fever of 38.6 °C, and blood tests revealed elevated C-reactive protein and monocyte levels. Despite differing initial assessments by specialists, a rheumatologist confirmed the diagnosis of post-COVID-19 monoarthritis. Physiotherapy was prescribed for 10 days, along with a variety of anti-inflammatory drugs. Fifty-two days after the first symptoms of monoarthritis, the ankle showed no signs of inflammation. Hematological and acute phase reactants were within the reference range, and no recurrence of symptoms occurred over the following 6 months. Conclusion : The case highlights clinicians’ need to recognize SARS-CoV-2 as a potential trigger for reactive arthritis, broadening our understanding of the virus’s systemic effects beyond the respiratory tract. A review of 8 published case reports confirms that SARS-CoV-2 infection can lead to inflammatory arthritis in male patients, typically resolving with NSAIDs and/or corticosteroids. Furthermore, emerging evidence links SARS-CoV-2 to the onset of diverse autoimmune conditions, underscoring the importance of vigilant long-term monitoring for new-onset autoimmune disorders in COVID-19 patients.