COVID-19 and rheumatoid arthritis crosstalk: Emerging association, therapeutic options and challenges

Saikat Dewanjee, Ramesh Kandimalla, Rajkumar Singh Kalra, Chandrasekhar Valupadas, Jayalakshmi Vallamkondu, Viswakalyan Kolli, Sarbani Dey Ray, Arubala P. Reddy, P. Hemachandra Reddy

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations


Hyperactivation of immune responses resulting in excessive release of pro-inflammatory mediators in alveoli/lung structures is the principal pathological feature of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The cytokine hyperactivation in COVID-19 appears to be similar to those seen in rheumatoid arthritis (RA), an autoimmune disease. Emerging evidence conferred the severity and risk of COVID-19 to RA patients. Amid the evidence of musculoskeletal manifestations involving immune-inflammation-dependent mechanisms and cases of arthralgia and/or myalgia in COVID-19, crosstalk between COVID-19 and RA is often debated. The present article sheds light on the pathological crosstalk between COVID-19 and RA, the risk of RA patients in acquiring SARS-CoV-2 infection, and the aspects of SARS-CoV-2 infection in RA development. We also conferred whether RA can exacerbate COVID-19 outcomes based on available clinical readouts. The mechanistic overlapping in immune-inflammatory features in both COVID-19 and RA was discussed. We showed the emerging links of angiotensin-converting enzyme (ACE)-dependent and macrophage-mediated pathways in both diseases. Moreover, a detailed review of immediate challenges and key recommendations for anti-rheumatic drugs in the COVID-19 setting was presented for better clinical monitoring and management of RA patients. Taken together, the present article summarizes available knowledge on the emerging COVID-19 and RA crosstalk and their mechanistic overlaps, challenges, and therapeutic options.

Original languageEnglish
Article number3291
Issue number12
StatePublished - Dec 2021


  • ACE
  • ACE2
  • Anti-rheumatic drugs
  • COVID-19
  • Cytokine storm
  • Immune response
  • Inflammation
  • Rheumatoid arthritis
  • SARS-CoV-2
  • Therapeutic options


Dive into the research topics of 'COVID-19 and rheumatoid arthritis crosstalk: Emerging association, therapeutic options and challenges'. Together they form a unique fingerprint.

Cite this