Skeletal and muscular manifestations of post-COVID syndrome: literature review

Abstract

The 2019 outbreak of a novel coronavirus infection in Wuhan City has resulted in a pandemic that has not only brought about global social change, but has also been a challenge for the entire medical community. The accumulation of material on this disease has revealed the multisystemic nature of internal organ damage with the development of new associated conditions, particularly those related to immunopathology and rheumatologic diseases. This review describes the literature on musculoskeletal symptoms during different periods of new-onset coronavirus infection (COVID-19). The paper defines the terms post-COVID syndrome and Long COVID, and describes clinical observations and the most common symptoms in adults and children. Clinical cases of joint syndrome are described in patients who have had a new coronavirus infection and no history of rheumatologic disease. Possible molecular pathogenesis of autoimmunity activation (cellular and humoral immune response as well as direct cytotoxic effect of the virus) both in acute period of coronavirus infection as well as during recuperation is also considered. Literature analysis of peculiarities of course of COVID-19 in patients with rheumatological diseases was carried out, in particular the risk of infection, its severe course and unfavourable outcome. In general, according to the analysis of the literature, musculoskeletal lesions occur more frequently between 3 and 10 weeks after the end of the acute stage of infection, most often manifested by muscle and joint pain, while the incidence of true reactive arthritis associated with COVID-19 is low. The pathogenesis of musculoskeletal damage requires further investigation and patients should be followed up for a longer period of time.