Musculoskeletal manifestations are common in both the acute and long-term phases of COVID-19. In the acute phase, fatigue, myalgia, and arthralgia are most common. Post-COVID syndrome can involve fatigue, arthralgia, myalgia, back pain, and muscle weakness in over 12 weeks. Importantly, some patients present only with musculoskeletal symptoms like fever and higher CRP without respiratory symptoms. Physiotherapy and judicious steroid use are recommended for long-term or bedridden COVID-19 patients.

1. Journal club on Musculoskeletal
Manifestations of COVID-19
Presented by Dr.Pushpendra

2. JB&JS Reviews 2022

3. • COVID-19 caused by infection with a new corona virus (SARS-
CoV-2), was first identified in Wuhan, People’s Republic of
China, in 2019
• COVID-19 is a disease that is challenging science, health-care
systems and humanity.

4. • In initial stages, the virus targets cells in the respiratory tract
by binding to the ACE2 receptor, which triggers the
inflammatory response characteristic of COVID-19.
• It is important to highlight that this receptor is also present in
other tissues, including muscle cells.
• In the acute phase of COVID-19, fatigue, myalgia, and
arthralgia are the most common musculoskeletal symptoms

5. • Post-COVID-19 syndrome(also termed “long COVID) is a group
of signs and symptoms that are present for >12 weeks.
The associated musculoskeletal manifestations are;
• Fatigue 34%
• Arthralgia 65%,
• Myalgia 42%
• new-onset back pain 55%
• muscle weakness 46% and poor physical performance

6. • An interesting cohort study by Hoong et al. highlights the
importance of musculoskeletal manifestations:
• it found that 25% of COVID-19 patients with musculoskeletal
symptoms had fever and did not have respiratory symptoms;
additionally, a higher prevalence of fever and higher CRP
levels were identified in patients with musculoskeletal
symptoms.
• Therefore, musculoskeletal symptoms are also important to
consider in the diagnosis process when COVID-19 is
suspected.

8. Take home massage....
• In long term bedridden pts need
physiotherapy
• Use Steroids judicially
•