Musculoskeletal involvement: COVID-19 and post COVID 19

Area of Science:

• Rheumatology
• Infectious Diseases
• Internal Medicine

Background:

• The pandemic of coronavirus disease 2019 (COVID-19) primarily impacted the lungs but also affected multiple organ systems.
• Musculoskeletal involvement is a significant manifestation of COVID-19, occurring during acute infection, as a side effect of treatments, and in post/long COVID-19 syndromes.

Purpose of the Study:

• To review the clinical manifestations, pathogenesis, and predictors of musculoskeletal involvement in COVID-19.
• To highlight the importance of accurate diagnosis and management of musculoskeletal pain in post-COVID-19 conditions.

Main Methods:

• Literature review of studies on COVID-19 and musculoskeletal manifestations.
• Analysis of reported symptoms, potential pathogenetic mechanisms (e.g., inflammation, ACE2), and risk factors for post-COVID musculoskeletal syndromes.

Main Results:

• Common symptoms include fatigue, myalgia, arthralgia, back pain, and muscle weakness, persisting or emerging in post-COVID syndromes.
• Potential pathogenetic factors include inflammation, hypoxia, muscle catabolism, and the renin-angiotensin system (ACE2).
• Medications like corticosteroids can induce myopathy and osteoporosis. Predictors for post-COVID musculoskeletal syndrome include female sex, obesity, elderly status, hospitalization, immobility, mechanical ventilation, and comorbidities.

Conclusions:

• Musculoskeletal pain is a common and often chronic issue following COVID-19.
• Understanding the pathogenesis involving inflammation and ACE2 is crucial for developing effective pain management and rehabilitation strategies.
• Accurate diagnosis is essential for appropriate patient care in the context of post-COVID musculoskeletal conditions.