Giant cell arteritis (GCA) is an inflammatory disease that affects the arteries, which often causes headaches, jaw pain, and vision problems. The exact cause is not known, but the infection is thought to play an important role. Immediately after the first wave of the COVID-19 pandemic, the number of GCA diagnoses increased markedly at the Royal National Hospital for Rheumatic Diseases in Bath, UK. In addition, there was an increase in the proportion of patients with visual complications. The finding is important for understanding the underlying mechanisms of the disease in GCA and supports the idea that a viral infection might be involved. It also has implications for the provision of local services.
Ben Mulhearn and colleagues estimated the incidence of GCA observed during the COVID-19 pandemic and compared it with data from 2019, before the success of the pandemic. The two different peaks of COVID-19 reflected by British hospital admissions of patients with COVID-19 positive allowed the authors to investigate the timing relationship between COVID-19 and incidence of GCA.
At the Royal National Hospital for Rheumatic Diseases in Bath, UK, there were 61 probable or definite diagnoses of GCA made in 2020 compared to 28 in 2019, representing an excess of 33 cases in 2020, or an increase of 118%. Considering the fact that 41% of the hospital’s recruitment population is over 50, this equates to an annual incidence rate of 13.7 per 100,000 in 2019 and 29.8 per 100,000 in 2020. The previously estimated regional incidence rate for the south-west of the UK was 21.6 per 100,000.
Significantly increased incidence of GCA may be the result of widespread infection in the local population, with SARS-CoV-2 as a driving factor. Possible mechanisms include, but are not limited to, endothelial disruption by the virus, the immune system targeting T-cell immunity from helper T cells, and activation of the monocyte-macrophage system. . More work is being done to evaluate the causal relationship between the two diseases, and it may be important to control the number of GCA referrals as the pandemic continues.
Provided by the European Alliance of Associations for Rheumatology
Citation: Increased giant cell arteritis associated with peak prevalence of COVID-19 (2021, June 18) recovered on June 19, 2021 at https://medicalxpress.com/news/2021-06-giant -cell-arteritis-peaks-covid-. html
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