AB1143 MUSCULOSKELETAL PAIN AS A PART OF THE RHEUMATIC SPECTRUM IN COVID-19

Abstract

BackgroundSince the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease 2019 (COVID-19) (1), our understanding of the underlying pathophysiology is constantly evolving in order to explain the wide range of heterogenic clinical manifestations (2). Nevertheless, limited data are available for the severity and multifactorial causality of musculoskeletal pain in COVID-19 patients (3).ObjectivesThis study aimed to evaluate the prevalence and intensity of rheumatic pain symptoms – arthralgia and myalgia and their association with anxiety and depression in a cohort of COVID-19 patients, hospitalized at the COVID-19 rheumatology department of the University Hospital St. Marina, Varna, Bulgaria.MethodsIn the present single-center cohort study, а prospective analysis was performed among COVID-19 patients who were hospitalized from 1 Oct 2021 to 20 Jan 2022 and self-reported for new-onset of musculoskeletal pain. All 226 patients (age 26 - 91 years) were treated for moderate or severe SARS-CoV-2 infection confirmed by laboratory tests, including positive antigen test or polymerase chain reaction (PCR) test, and imaging modality. Detailed disease history and clinical examination were carried out by a fully certified rheumatologist. All patients who reported new-onset of musculoskeletal pain during the acute phase of the infection, participated on a voluntary basis in a questionnaire survey, by completed Zung self-rating anxiety scale (SAS), Zung self-rating depression scale (SDS) and visual analogue scale (VAS) for arthralgia and myalgia. The questionnaire form also elicited information on sociodemographic characteristics of the patients. In all patients, inflammation and thrombotic biomarkers were assessed. The level of significance was set to 0.05.ResultsAmong all 226 COVID-19 patients with musculoskeletal pain, 46.5% (n =105) were women and 53.5% (n = 121), were men. Mean age was 65.6 years. We found a significant correlation of depression and anxiety scales scores with pain intensity (both arthralgia and myalgia), all < 0.001. A multiple regression analysis found that SDS and SAS accounted for significant variance in the prediction of muscle pain (β = 0.441, p < 0.001; β = 0.293, p = 0.003, respectively) while SDS significantly predicted joint pain (β = 0.341, p = 0.043). On the other hand, musculoskeletal pain does not correlate with any of inflammation and thrombotic biomarkers assessed in SARS-CoV-2 patients (p > 0.05).ConclusionRheumatic pain manifestations are part of the heterogeneous spectrum of COVID-19 disease. The pain intensity is significantly associated with anxiety and depression symptoms and does not correlate with inflammation and thrombotic biomarkers.