Musculoskeletal Manifestations of COVID-19: A Systematic Search and Review

Abstract

Introduction: Coronavirus disease (COVID-19) started its journey from Wuhan, China and gradually became a pandemic. COVID-19 often affects the respiratory system, but symptoms may include fatigue, myalgia, arthralgia, arthritis, spine-, and bone pain as presenting complaints. In the present systematic search and review, we aim to highlight the musculoskeletal manifestations during COVID-19. Methods: Using PubMed Central and Google Scholar search engines, we used as key words “muscle pain”, “joint pain”, “body ache”, “fatigue”, in Covid-19 patients. Results: After screening, a total of 76 articles were included following inclusion criteria dated between January 1 and July 1, 2020. All articles were published in English comprising 36558 COVID-19 cases. In cross sectional studies, fatigue was found in 55%, myalgia in 26%, and arthralgia in 20%, respectively. In cohort studies, fatigue was found in 35%, myalgia in 15%, and arthralgia in 5%, respectively. Sporadic case reports also mention back pain, bone pain, myositis and arthritis as presenting symptoms of COVID-19.Discussion: Fatigue was the most frequent musculoskeletal (MSK) manifestion of COVID-19 followed by myalgia and joint pain. The frequency of the different MSK manifestations in COVID-19 may vary widely among different geographic regions. Conclusions: MSK like fatigue, myalgia and arthralgia are frequent symptoms in COVID-19 patients and may vary in different countries.