{"doi":"10.31219/osf.io/pzehv","title":"COVID-19 and Rheumatoid Arthritis Crosstalk: Emerging association, therapeutic options, and challenges","abstract":"Excessive immune activation and cytokine release in alveoli/lung structures is a prominent sign of coronavirus disease 2019 (COVID-19) pathology caused by infectious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The progressive sign of pro-inflammatory cytokines elicited in COVID-19 clinically resembles hyper immune-reactive features often seen in rheumatoid arthritis (RA), an autoimmune disorder. Recent clinical data from the ongoing COVID-19 pandemic 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 debated. The present review sheds light on the overlapping COVID-19 and RA clinical features, aspects of SARS-CoV-2 infection in RA development, and associated risks. It also confers whether RA can worsen COVID-19 outcomes based on available clinical readouts. To gain mechanistic insights into the overlapping immune-inflammatory features in SARS-CoV-2 infection and RA, we reviewed the emerging links of angiotensin-converting enzyme (ACE)-dependent and macrophage-mediated pathways. 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, present review summarizes available knowledge on the emerging COVID-19 and RA crosstalk and their mechanistic overlaps, challenges, and therapeutic options.","journal":"OSF Preprints (OSF Preprints)","year":2021,"id":214124,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9625,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":648295,"name":"Saikat Dewanjee","orcid":"0000-0001-9085-4226","position":1,"is_corresponding":false},{"id":337428,"name":"Rajkumar Singh Kalra","orcid":"0000-0002-8181-457X","position":2,"is_corresponding":false},{"id":807542,"name":"Chandrasekhar Valupadas","orcid":null,"position":3,"is_corresponding":false},{"id":287174,"name":"Jayalakshmi Vallamkondu","orcid":null,"position":4,"is_corresponding":false},{"id":807012,"name":"Viswakalyan Kolli","orcid":"0000-0001-7997-0103","position":5,"is_corresponding":false},{"id":807543,"name":"P. Arubala Reddy","orcid":null,"position":6,"is_corresponding":false},{"id":231340,"name":"P. Hemachandra Reddy","orcid":"0000-0002-9560-9948","position":7,"is_corresponding":false},{"id":285497,"name":"Ramesh Kandimalla","orcid":"0000-0002-3313-4393","position":0,"is_corresponding":true}],"reference_count":88,"raw_metadata":null,"created_at":"2026-07-18T23:52:41.672172Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}