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Musculoskeletal complications in long COVID-19: A systematic review
Raktim Swarnakar1, Shoibam Jenifa1, Sanjay Wadhwa2
1Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India.
Insights
Long COVID frequently causes musculoskeletal issues like fatigue, myalgia, and arthralgia. Research gaps exist in understanding and treating these long COVID complications, particularly rehabilitation strategies.
Area of Science:
- Rheumatology
- Infectious Diseases
- Rehabilitation Medicine
Background:
- Coronavirus disease 2019 (COVID-19) has led to various long-term health issues.
- Musculoskeletal symptoms are common in acute COVID-19 but underreported in long COVID.
- Persistent fatigue, myalgia, and arthralgia are frequently reported by COVID-19 survivors.
Purpose of the Study:
- To systematically review and identify musculoskeletal complications associated with long COVID.
- To assess the existing literature on rehabilitation interventions for long COVID musculoskeletal issues.
Main Methods:
- A systematic review of existing systematic reviews and meta-analyses was conducted.
- Screened 63 articles, including 24 relevant studies.
- Identified specific focus areas within the included literature, noting limitations.
Main Results:
- Fatigue emerged as the most prevalent musculoskeletal complication in long COVID.
- Myalgia and arthralgia were also commonly reported.
- A significant lack of studies specifically addressing rehabilitation interventions for long COVID musculoskeletal issues was found.
Conclusions:
- Fatigue, myalgia, and arthralgia are significant musculoskeletal complications of long COVID.
- There is a critical need for research into standardized rehabilitation interventions for these complications.
- Further studies are essential to address functional impairment and guide effective treatment strategies.
Background:
Coronavirus disease 2019 (COVID-19) has crippled humanity since early 2020. Various sequelae of COVID-19 have been reported in different body systems. Musculoskeletal symptoms are widely reported during COVID-19 infection, but musculoskeletal complications in long COVID-19 are underreported. However, post-COVID-19 survivors have reported complaints of persisting or new-onset fatigue, myalgia, arthralgia, arthritis, muscle weakness, etc in clinical practice. The well-known detrimental effects of steroids on the musculoskeletal system coupled with their over-the-counter availability can also be anticipated since they were the cornerstone of life-saving management in this pandemic.
Aim:
To determine the musculoskeletal complications in long COVID.
Methods:
We performed a systematic review of 'systematic reviews and meta-analyses'.
Results:
Of the 63 articles screened, 24 articles were included. Two articles specifically discussed children and adolescents. One article discussed rehabilitation intervention. No article addressed rehabilitation of musculoskeletal issues in long COVID-19 in particular. Fatigue was the most common musculoskeletal complication.
Conclusion:
Fatigue is found to be very common along with myalgia and arthralgia. There were no studies on rehabilitation intervention in musculoskeletal complications specifically. Considering the lacuna in literature and the needs of the current situation, further studies are warranted to standardize effective rehabilitation interventions in musculoskeletal complications. More homogenous studies are needed. Studies on functional impairment due to musculoskeletal involvement are essential.
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