JIA Flares Increase with COVID-19 Lockdown

According to a recent article, children with juvenile idiopathic arthritis experienced higher rates of joint inflammation during the COVID-19 lockdown.

Juvenile Idiopathic Arthritis (JIA)

Juvenile idiopathic arthritis (JIA) proves that arthritis isn’t just a sign of old age. We can break this condition down by word:

  • Juvenile = young
  • Idiopathic = of unknown origin
  • Arthritis = inflammation of the joint

There are a number of different types of juvenile idiopathic arthritis. While all of these types share some common characteristics, they each have a little something that sets them apart. The different types of JIA are:

  • Oligoarticular juvenile idiopathic arthritis
  • Systemic juvenile idiopathic arthritis
  • Psoriatic juvenile idiopathic arthritis
  • Polyarticular juvenile idiopathic arthritis—rheumatoid factor negative
  • Polyarticular juvenile idiopathic arthritis—rheumatoid factor positive
  • Undifferentiated arthritis
  • Enthesitis-related juvenile idiopathic arthritis

Even though there are many types of JIA, they all share some common symptoms—specifically pain in the joint. This pain can manifest as swelling, stiffness, inflammation, and/or limited range of motion and usually occurs in the hands, feet, and knees.

Limitations During the Lockdown

As pointed out by Roberta Naddei, MD, of the University of Naples Federico II, the lockdown caused a number of issues for children with JIA. These issues include non-essential health care visits being limited, home confinement leading to physical inactivity, and general routine management issues.

Single-Center Retrospective Study

Naddei and her colleagues conducted a single-center retrospective study of patients who were admitted to the pediatric unit at the University of Naples Federico II. The study was conducted to analyze the rate of disease flare among children with JIA before and during the COVID-19 lockdown.

A total of 126 patients were put into “Group A” based on if they presented with inactive JIA between Sept. 1, 2018, and March 9, 2019. Furthermore, a total of 124 similar patients were put into “Group B” based on if they were admitted between Sept. 1, 2019, and March 9, 2020.

Researchers compared the two groups off various data points, and they found that there was a significantly higher rate of JIA flares during the lockdown of the first wave of the pandemic. It pointed out that despite the fact that drug adherence remained stable, there was a higher rate of relapse.

“This finding has considerable clinical implications since restrictive measures are still occurring in several countries as the pandemic evolves. Our data highlight the need for implementing health care management of patients with JIA, including personalized at-home-exercise programs, in case of new lockdowns.”

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