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Giant Cell Arteritis and COVID-19: Similarities and Discriminators. A Systematic Literature Review

Mehta, P; Sattui, SE; Van der Geest, K; Brouwer, E; Conway, R; Putman, MS; Robinson, PC; (2021) Giant Cell Arteritis and COVID-19: Similarities and Discriminators. A Systematic Literature Review. The Journal of Rheumatology , 48 (7) pp. 1053-1059. 10.3899/jrheum.200766. Green open access

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Abstract

OBJECTIVE: To identify shared and distinct features of giant cell arteritis (GCA) and Coronavirus disease 2019 (COVID-19) to reduce diagnostic error that could cause delays in correct treatment. METHODS: Two systematic literature reviews determined the frequency of clinical features of GCA and COVID-19 in published reports. Frequencies in each disease were summarised using median and range. RESULTS: Headache was common in GCA but was also observed in COVID-19 (66% for GCA, 10% for COVID-19). Jaw claudication or visual loss (43% and 26% in GCA, respectively) were not reported in COVID-19. Both diseases featured fatigue (38% for GCA, 43% for COVID-19) and elevated inflammatory markers (CRP elevated in 100% of GCA, 66% of COVID-19), but platelet count was elevated in 47% of GCA but 4% of COVID-19. Cough and fever were commonly reported in COVID-19 and less frequently in GCA (cough, 63% for COVID-19 versus 12% for GCA; fever, 83% for COVID-19 versus 27% for GCA). Gastrointestinal upset was occasionally reported in COVID-19 (8%), rarely in GCA (4%). Lymphopenia was more common in COVID-19 than GCA (53% in COVID-19, 2% in GCA). Alteration of smell and taste been described in GCA but their frequency is unclear. CONCLUSION: Overlapping features of GCA and COVID-19 include headache, fever, elevated CRP and cough. Jaw claudication, visual loss, platelet count and lymphocyte count may be more discriminatory. Physicians should be aware of the possibility of diagnostic confusion. We have designed a simple checklist to aid evidence-based evaluation of patients with suspected GCA.

Type: Article
Title: Giant Cell Arteritis and COVID-19: Similarities and Discriminators. A Systematic Literature Review
Location: Canada
Open access status: An open access version is available from UCL Discovery
DOI: 10.3899/jrheum.200766
Publisher version: https://doi.org/10.3899/jrheum.200766
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10114016
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