Abstract: Modern Rheumatology, 00, 2022, 1–6 DOI: https://doi.org/10.1093/mr/roac074 Advance Access Publication Date: 21 July 2022 Original Article COVID-19 in familial Mediterranean fever: Clinical course and complications related to primary disease a Faculty of Medicine Hospital, Department of Rheumatology, Gazi University, Ankara, Turkey Faculty of Medicine Hospital, Department of Rheumatology, Dokuz Eylul University, Izmir, Turkey c Faculty of Medicine Hospital, Department of Rheumatology, Eskisehir Osmangazi University, Eskisehir, Turkey d Faculty of Medicine Hospital, Department of Internal Medicine, Gazi University, Ankara, Tukey b *Correspondence: Aslıhan Avanoglu Guler; aslihanavanoglu@gmail.com; Gazi University, Department of Internal Medicine & Rheumatology, Gazi Universitesi Hastaneleri, Emniyet Mahallesi, Mevlana Bulvarı, Yenimahalle/Ankara 06560, Turkey. ABSTRACT Objectives: To evaluate the impact of familial Mediterranean fever (FMF) features on the clinical course and outcomes of coronavirus disease 2019 (COVID-19) and clinical course of FMF after COVID-19. Methods: Consecutive FMF patients with COVID-19 were enrolled from three referral hospitals. Clinical features of FMF and detailed COVID-19 information were obtained from patient interviews and medical records. Results: Seventy-three FMF patients were included in the study. 94.5% of patients had clinical symptoms of COVID-19. We found 24.7% hospitalization, 12.3% respiratory support, 4.1% intensive care unit admission, 6.8% complication, and 1.4% mortality rate in patients. The risk factors of hospitalization for respiratory support were male gender [OR: 7.167 (95% CI: 1.368–37.535)], greater age [OR: 1.067 (95% CI: 1.016–1.121)], and non-adherence to colchicine treatment before the infection [OR: 7.5 (95% CI: 1.348–41.722)]. One-third of patients had reported attacks after COVID-19. The patterns of triggered attacks were fever, peritonitis, pleuritis, transient arthritis, chronic knee mono-arthritis, and protracted febrile myalgia. Conclusions: FMF characteristics were not associated with worse outcomes of COVID-19. Colchicine non-adherence was the risk factor of hospitalization for oxygen support. The rate of FMF attacks after COVID-19 is prominently increased, with some of them being protracted and destructive. KEYWORDS: Coronovirus-19 disease; familial Mediterranean fever; clinical course; complication; outcome