Rheumatoid Arthritis and Covid-19 Acute Respiratory Distress Syndrome: A Case Report

Abstract

Rheumatoid arthritis (RA) is a progressive and systemic inflammatory disease of unknown cause that usually enters a chronic phase. Treatment of rheumatoid arthritis mostly consists of immunosuppressive agents and corticosteroids. These agents put patients at risk of infection (COVID-19). RA disease in common with coronavirus infection can trigger immune system for cytokine storm that is potentially a manifestation of systemic inflammation. We report an unusual case of rheumatoid arthritis with a combination of COVID-19 respiratory distress and its successful management in critical care settings. It seems that an early intubation strategy would be beneficial for young RA COVID-19 patients with severe leukocytosis. Also, patients with leukocytosis should be closely monitored for early detection of acute respiratory distress syndrome. As RA patients are at risk of co-infection, it is recommended to keep them in a separate room (preferably an isolated room).