Clinical indices and laboratory markers for evaluating the immune-mediated inflammation in rheumatoid arthritis: the impact of COVID-19

Rheumatoid arthritis (RA) is an immune-mediated inflammatory disease of unknown etiology that represents a considerable burden for both the patient and the healthcare system. The degree to which inflammation is being controlled determines the prognosis; therefore, achieving remission or low disease activity is of paramount importance to medical practitioners. The effectiveness of the currently employed treatment regimen for a specific patient is determined by the disease activity indices and the change in their values during treatment. The commonly used RA disease activity indices are the result of a painstaking search for the optimal set of clinical, laboratory and instrumental parameters reflecting the underlying pathogenesis of inflammation in RA spanning half a century. Routine laboratory tests not included in these indices can nevertheless provide additional valuable information regarding the disease. The new coronavirus infection, COVID-19, has similar pathogenetic mechanisms with immunoinflammatory rheumatic diseases, and its clinical and laboratory consequences in the form of postcovid-19 syndrome, make it difficult to assess the activity of RA using existing activity indices, raise the question of the need to take them into account when assessing the effectiveness and choosing the tactics of treatment of a patient with RA.