Ab0062 Covid-19: The Rise of Rheumatoid Arthritis

Background: Over 700 mln people worldwide have been infected with SARS-CoV-2 and more than 7 mln of them have died due to COVID-19 since 2020. Nowadays, rheumatologists are encountering an upsurge of autoimmune rheumatic diseases (ARDs) after COVID-19 and COVID-19 vaccination. Rheumatoid arthritis (RA) is one of the common ARDs with 0.5-2% global prevalence. Numerous publications, including own reports, have associated RA debute with SARS-CoV-2 infection or COVID-19 vaccination. Four large cohort studies has revealed an increased risk of RA and many other ARDs amongst COVID-19 survivors. Objectives: The aim of our study was to overview RA incidence dynamic in Central Asia in the pandemic. Another goal is to perform a literature review. Methods: We have analyzed the official RA morbidity data from Kyrgyzstan, Uzbekistan and Kazakhstan reported in 2019-2022. The statistical data were provided by republic centres of electronic healthcare of the central Asian countries. We have also retrieved and overviewed 2020-2023 English publications indexed in MEDLINE/PubMed and Scopus using «rheumatoid arthritis», «SARS-CoV-2» or «COVID-19» keywords. Results: The analysis of the statistical data on RA morbidity revealed a substantial increase of the absolute number of patients in Kyrgyzstan, Uzbekistan and Kazakhstan. The increase relates to both the number of dispensary follow-up and newly diagnosed patients. The number of registered RA patients in Kazakhstan elevated from 41,044 in 2020 to 66,018 in 2022 (a 61% increase). In the past two years, population of Kazakhstani growth reached only 10.4%. The increase of newly diagnosed RA patients in Uzbekistan and Kyrgyzstan accounted for 29% and 31%, respectively, during the same period. Our overview of the literature data convincingly pointed to the association of COVID-19 with autoimmunity and ARDs. Conclusion: Based on the analysis of the retrieved literature data, we conclude that SARS-CoV-2 infection and COVID-19 vaccination may trigger RA and other ARDs. The reported remarkable increase of RA figures in the three Central Asian countries may prove our prediction of RA increase due to the pandemic presented at APLAR 2020. Having said that, the official statistical data can be confounded by multiple factors such as improved RA diagnostics and increased number of qualified rheumatologists. Skewed reporting and recording morbidity data might also influence the official statistics during the pandemic. The expected global increase of ARDs in the post-pandemic period may lead to the stretching of human and other resources. Today public health to face the growing need of training of new rheumatologists, expanding rheumatology units, and supplying drugs. The EULAR 24 CONGRESS may serve as a platform for the discussion. And of course, large-scale international studies are warranted to examine the dynamic of RA across the world in the aftermath of the pandemic. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: Chokan Baimukhamedov AstraZeneca, Bayer, Janssen.