Abstract
Context: Long COVID, a condition that persists after the acute phase of COVID-19, poses a significant burden, with 10 - 45% of recovered patients experiencing persistent symptoms. Among these, approximately 46% report musculoskeletal pain. This narrative review explores the potential connections between gut microbiota, Long COVID, and musculoskeletal pain, aiming to introduce new therapeutic avenues and preventive strategies for managing musculoskeletal symptoms in Long COVID patients. Evidence Acquisition: A comprehensive search was conducted using Google Scholar, Lens.org, and ConnectedPaper.com to identify relevant articles published between 2019 and 2024. Keywords related to microbiota, Long COVID, and musculoskeletal pain were used. Articles were selected based on predefined inclusion and exclusion criteria, and their quality was assessed. Data from the selected articles were synthesized to provide an overview of the interplay between microbiota, Long COVID, and musculoskeletal pain. Results: Recent research highlights the significant role of gut microbiota in modulating immune responses and systemic inflammation. Dysbiosis has been linked to the severity and progression of COVID-19 and the persistence of Long COVID symptoms. Individuals with Long COVID often experience new-onset musculoskeletal manifestations, such as joint pain, myalgia, and chronic musculoskeletal pain. Additionally, gut dysbiosis has been associated with conditions like lower back pain and knee osteoarthritis. This suggests that the relationship between gut dysbiosis and musculoskeletal problems in general may also extend to musculoskeletal pain in Long COVID patients, indicating broader implications for musculoskeletal outcomes. Therapeutic strategies targeting the gut microbiota, such as probiotics, prebiotics, and dietary interventions, have shown promise in managing these symptoms and improving overall health outcomes. Conclusions: The evidence underscores the importance of understanding the microbiota-musculoskeletal nexus in Long COVID. Gut dysbiosis contributes to systemic inflammation, exacerbating musculoskeletal symptoms in Long COVID patients. The associations between gut dysbiosis and other musculoskeletal conditions emphasize the need for microbiota-targeted therapeutic strategies. Future research should focus on elucidating the mechanisms linking gut dysbiosis to musculoskeletal pain, exploring the gut-brain axis, and developing personalized approaches to modulate the microbiota. Advancing our understanding of this nexus can pave the way for innovative therapeutic strategies to address the complex health challenges posed by Long COVID and other musculoskeletal conditions.
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