The Musculoskeletal Involvement After Mild to Moderate COVID-19 Infection

Patty K Dos Santos, Emilly Sigoli, Lorenna J G Bragança, Anabelle S Cornachione, Patty K Dos Santos, Emilly Sigoli, Lorenna J G Bragança, Anabelle S Cornachione

Abstract

COVID-19, a disease caused by the novel coronavirus SARS-CoV-2, has been drastically affecting the daily lives of millions of people. COVID-19 is described as a multiorgan disease that affects not only the respiratory tract of infected individuals, but it has considerable effects on the musculoskeletal system, causing excessive fatigue, myalgia, arthralgia, muscle weakness and skeletal muscle damage. These symptoms can persist for months, decreasing the quality of life of numerous individuals. Curiously, most studies in the scientific literature focus on patients who were hospitalized due to SARS-CoV-2 infection and little is known about the mechanism of action of COVID-19 on skeletal muscles, especially of individuals who had the mild to moderate forms of the disease (non-hospitalized patients). In this review, we focus on the current knowledge about the musculoskeletal system in COVID-19, highlighting the lack of researches investigating the mild to moderate cases of infection and pointing out why it is essential to care for these patients. Also, we will comment about the need of more experimental data to assess the musculoskeletal manifestations on COVID-19-positive individuals.

Keywords: COVID-19; SARS-CoV-2; long COVID; mild to moderate COVID-19; muscle symptoms; musculoskeletal system; non-hospitalized individuals.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 dos Santos, Sigoli, Bragança and Cornachione.

Figures

FIGURE 1
FIGURE 1
Structure of SARS-CoV-2. Schematic representation of SARS-CoV-2 virus structure highlighting its four major structural proteins: the spike glycoprotein (S), the envelope protein (E), the nucleocapsid protein (N) and the membrane glycoprotein (M). The RNA viral is also showed.
FIGURE 2
FIGURE 2
Mechanisms of action of SARS-CoV-2 on the skeletal muscle tissue. (A) Direct mechanism via SARS-CoV-2 binding to receptors on the skeletal muscle cell surface and entry of the virus into the cell. Several types of musculoskeletal cells express ACE2 and/or TMPRSS2, which allows this type of direct mechanism of action of the virus. (B) Indirect mechanism considering the adverse effects of the elevated inflammatory process (“cytokine storm”) caused by SARS-CoV-2 infection on the musculoskeletal tissue. The deregulated release of cytokines and chemokines (IL-6, IL-1β, IL-8, IFN-γ, IP-10, TNF-α) by the immune system results in exacerbated inflammation that can lead to multi-organ injuries. Both mechanisms (A,B) can affect the musculoskeletal system, causing manifestations such as fatigue and myalgia in symptomatic COVID-19 individuals. ACE2: angiotensin-converting enzyme 2; IFN-γ: interferon-gamma; IL-1β: interleukin-1β; IL-6: interleukin-6; IL-8: interleukin-8; IP-10: interferon-gamma inducible protein 10; TMPRSS2: transmembrane protease serine 2; TNF-α: tumor necrosis factor alpha.
FIGURE 3
FIGURE 3
Common muscle symptoms of COVID-19. Fatigue, arthralgia (joint pain), myalgia (muscle pain) and muscle weakness have been reported as initial and common symptoms by SARS-CoV-2-positive individuals. These extenuating symptoms can affect the daily lives of numerous individuals, reducing their quality of life.
FIGURE 4
FIGURE 4
The four main types of studies comprising COVID-19 and the skeletal muscle. (i) case reports and original articles of hospitalized individuals (severe COVID-19; functional and morphologic techniques); (ii) Review and observational articles citing only the musculoskeletal symptoms (mild and severe COVID-19; no experimental data); (iii) Follow-up studies of patients with persistent muscle symptoms (mild and severe COVID-19; no experimental data); and (iv) Neurological studies that includes musculoskeletal symptoms (mild to moderate and severe COVID-19; functional assays). ICU = intensive care unit. Figure produced using Servier Medical Art (smart.servier.com).

References

    1. Abdelrahman Z., Li M., Wang X. (2020). Comparative Review of SARS-CoV-2, SARS-CoV, MERS-CoV, and Influenza A Respiratory Viruses. Front. Immunol. 11, 1–14. 10.3389/fimmu.2020.552909
    1. Abdullahi A., Candan S. A., Abba M. A., Bello A. H., Alshehri M. A., Afamefuna Victor E., et al. (2020). Neurological and Musculoskeletal Features of COVID-19: A Systematic Review and Meta-Analysis. Front. Neurol. 11, 1–14. 10.3389/fneur.2020.00687
    1. Afshar-Oromieh A., Prosch H., Schaefer-Prokop C., Bohn K. P., Alberts I., Mingels C., et al. (2021). A Comprehensive Review of Imaging Findings in COVID-19 - Status in Early 2021. Eur. J. Nucl. Med. Mol. Imaging 48, 2500–2524. 10.1007/s00259-021-05375-3
    1. Agergaard J., Leth S., Pedersen T. H., Harbo T., Blicher J. U., Karlsson P., et al. (2021). Myopathic Changes in Patients with Long-Term Fatigue after COVID-19. Clin. Neurophysiol. 132, 1974–1981. 10.1016/j.clinph.2021.04.009
    1. Ahmad I., Rathore F. A. (2020). Neurological Manifestations and Complications of COVID-19: A Literature Review. J. Clin. Neurosci. 77, 8–12. 10.1016/j.jocn.2020.05.017
    1. Aiyegbusi O. L., Hughes S. E., Turner G., Rivera S. C., McMullan C., Chandan J. S., et al. (2021). Symptoms, Complications and Management of Long COVID: a Review. J. R. Soc. Med. 114, 428–442. 10.1177/01410768211032850
    1. Akbar M. R., Pranata R., Wibowo A., Lim M. A., Sihite T. A., Martha J. W. (2021). The Prognostic Value of Elevated Creatine Kinase to Predict Poor Outcome in Patients with COVID-19 - A Systematic Review and Meta-Analysis. Diabetes Metab. Syndr. Clin. Res. Rev. 15, 529–534. 10.1016/j.dsx.2021.02.012
    1. Akbarialiabad H., Taghrir M. H., Abdollahi A., Ghahramani N., Kumar M., Paydar S., et al. (2021). Long COVID, a Comprehensive Systematic Scoping Review. Infection 49, 1163–1186. 10.1007/s15010-021-01666-x
    1. Aksan F., Nelson E. A., Swedish K. A. (2020). A COVID-19 Patient with Intense Burning Pain. J. Neurovirol. 26, 800–801. 10.1007/s13365-020-00887-4
    1. Ali A. M., Kunugi H. (2021). Skeletal Muscle Damage in Covid-19: A Call for Action. Medicina 57, 372. 10.3390/medicina57040372
    1. Alrubaye R., Choudhury H. (2020). Severe Rhabdomyolysis in a 35-Year-Old Woman with COVID-19 Due to SARS-CoV-2 Infection: A Case Report. Am. J. Case Rep. 21, e926733. 10.12659/AJCR.926733
    1. Amenta E. M., Spallone A., Rodriguez-Barradas M. C., El Sahly H. M., Atmar R. L., Kulkarni P. A. (2020). Postacute COVID-19: An Overview and Approach to Classification. Open Forum Infect. Dis. 7, 1–7. 10.1093/ofid/ofaa509
    1. Anand P., Slama M. C. C., Kaku M., Ong C., Cervantes‐Arslanian A. M., Zhou L., et al. (2020). COVID ‐19 in Patients with Myasthenia Gravis. Muscle Nerve 62, 254–258. 10.1002/mus.26918
    1. Andalib S., Biller J., Di Napoli M., Moghimi N., McCullough L. D., Rubinos C. A., et al. (2021). Peripheral Nervous System Manifestations Associated with COVID-19. Curr. Neurol. Neurosci. Rep. 21, 9. 10.1007/s11910-021-01102-5
    1. Andrade-Junior M. C. d., Salles I. C. D. d., de Brito C. M. M., Pastore-Junior L., Righetti R. F., Yamaguti W. P. (2021). Skeletal Muscle Wasting and Function Impairment in Intensive Care Patients with Severe COVID-19. Front. Physiol. 12, 1–13. 10.3389/fphys.2021.640973
    1. Anker M. S., Landmesser U., Haehling S., Butler J., Coats A. J. S., Anker S. D. (2021). Weight Loss, Malnutrition, and Cachexia in COVID‐19: Facts and Numbers. J. Cachexia, Sarcopenia Muscle 12, 9–13. 10.1002/jcsm.12674
    1. Ashraf O., Young M., Malik K. J., Cheema T. (2020). Systemic Complications of COVID-19. Crit. Care Nurs. Q. 43, 390–399. 10.1097/CNQ.0000000000000324
    1. Augustin M., Schommers P., Stecher M., Dewald F., Gieselmann L., Gruell H., et al. (2021). Post-COVID Syndrome in Non-hospitalised Patients with COVID-19: a Longitudinal Prospective Cohort Study. The Lancet Reg. Health - Europe 6, 100122. 10.1016/j.lanepe.2021.100122
    1. Bahouth S., Chuang K., Olson L., Rosenthal D. (2021). COVID-19 Related Muscle Denervation Atrophy. Skeletal Radiol. 50, 1717–1721. 10.1007/s00256-021-03721-y
    1. Baj J., Karakuła-Juchnowicz H., Teresiński G., Buszewicz G., Ciesielka M., Sitarz E., et al. (2020). COVID-19: Specific and Non-specific Clinical Manifestations and Symptoms: The Current State of Knowledge. Jcm 9, 1753. 10.3390/jcm9061753
    1. Balcom E. F., Nath A., Power C. (2021). Acute and Chronic Neurological Disorders in COVID-19: Potential Mechanisms of Disease. Brain 144, 3576–3588. 10.1093/brain/awab302
    1. Batur E. B., Korez M. K., Gezer I. A., Levendoglu F., Ural O. (2021). Musculoskeletal Symptoms and Relationship with Laboratory Findings in Patients with COVID‐19. Int. J. Clin. Pract. 75, e14135. 10.1111/ijcp.14135
    1. Bax F., Lettieri C., Marini A., Pellitteri G., Surcinelli A., Valente M., et al. (2021). Clinical and Neurophysiological Characterization of Muscular Weakness in Severe COVID-19. Neurol. Sci. 42, 2173–2178. 10.1007/s10072-021-05110-8
    1. Bohn M. K., Hall A., Sepiashvili L., Jung B., Steele S., Adeli K. (2020). Pathophysiology of COVID-19: Mechanisms Underlying Disease Severity and Progression. Physiology 35, 288–301. 10.1152/physiol.00019.2020
    1. Broussard S. R., McCusker R. H., Novakofski J. E., Strle K., Shen W. H., Johnson R. W., et al. (2004). IL-1β Impairs Insulin-like Growth Factor I-Induced Differentiation and Downstream Activation Signals of the Insulin-like Growth Factor I Receptor in Myoblasts. J. Immunol. 172, 7713–7720. 10.4049/jimmunol.172.12.7713
    1. Brüssow H., Timmis K. (2021). COVID ‐19: Long Covid and its Societal Consequences. Environ. Microbiol. 23, 4077–4091. 10.1111/1462-2920.15634
    1. Burn E., Tebé C., Fernandez-Bertolin S., Aragon M., Recalde M., Roel E., et al. (2021). The Natural History of Symptomatic COVID-19 during the First Wave in Catalonia. Nat. Commun. 12, 1–12. 10.1038/s41467-021-21100-y
    1. Byler J., Harrison R., Fell L. L. (2021). Rhabdomyolysis Following Recovery from Severe COVID-19: A Case Report. Am. J. Case Rep. 22, e931616. 10.12659/AJCR.931616
    1. Cabañes-Martínez L., Villadóniga M., González-Rodríguez L., Araque L., Díaz-Cid A., Ruz-Caracuel I., et al. (2020). Neuromuscular Involvement in COVID-19 Critically Ill Patients. Clin. Neurophysiol. 131, 2809–2816. 10.1016/j.clinph.2020.09.017
    1. Callard F., Perego E. (2021). How and Why Patients Made Long Covid. Soc. Sci. Med. 268, 113426. 10.1016/j.socscimed.2020.113426
    1. Capaccione K., Yang H., West E., Patel H., Ma H., Patel S., et al. (2021). Pathophysiology and Imaging Findings of COVID-19 Infection: An Organ-System Based Review. Acad. Radiol. 28, 595–607. 10.1016/j.acra.2021.01.022
    1. Carcamo Garcia M. H., Garcia Choza D. D., Salazar Linares B. J., Diaz M. M. (2021). Neurological Manifestations of Patients with Mild-To-Moderate COVID-19 Attending a Public Hospital in Lima, Peru. eNeurologicalSci 23, 100338. 10.1016/j.ensci.2021.100338
    1. Carvalho-Schneider C., Laurent E., Lemaignen A., Beaufils E., Bourbao-Tournois C., Laribi S., et al. (2021). Follow-up of Adults with Noncritical COVID-19 Two Months after Symptom Onset. Clin. Microbiol. Infect. 27, 258–263. 10.1016/j.cmi.2020.09.052
    1. Centers for Disease Control and Prevention (2021). Symptoms of COVID-19. Atlanta, Georgia, USA: CDC, 1. Available at: (Accessed September 2, 2021).
    1. Chan K. H., Farouji I., Abu Hanoud A., Slim J. (2020). Weakness and Elevated Creatinine Kinase as the Initial Presentation of Coronavirus Disease 2019 (COVID-19). Am. J. Emerg. Med. 38, 1548.e1–1548.e3. 10.1016/j.ajem.2020.05.015
    1. Chevinsky J. R., Tao G., Lavery A. M., Kukielka E. A., Click E. S., Malec D., et al. (2021). Late Conditions Diagnosed 1-4 Months Following an Initial Coronavirus Disease 2019 (COVID-19) Encounter: A Matched-Cohort Study Using Inpatient and Outpatient Administrative Data-United States, 1 March-30 June 2020. Clin. Infect. Dis. 73, S5–S16. 10.1093/cid/ciab338
    1. Chilamakuri R., Agarwal S. (2021). COVID-19: Characteristics and Therapeutics. Cells 10, 206–229. 10.3390/cells10020206
    1. Chinese Center for Disease Control and Prevention (2020). The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) - China, 2020. CDC Wkly 2, 113–122. 10.2139/ssrn.3548755
    1. Chopra N., Chowdhury M., Singh A. K., Ma K., Kumar A., Ranjan P., et al. (2021). Clinical Predictors of Long COVID-19 and Phenotypes of Mild COVID-19 at a Tertiary Care centre in India. DD&T 15, 156–161. 10.5582/ddt.2021.01014
    1. Cipollaro L., Giordano L., Padulo J., Oliva F., Maffulli N. (2020). Musculoskeletal Symptoms in SARS-CoV-2 (COVID-19) Patients. J. Orthop. Surg. Res. 15, 1–7. 10.1186/s13018-020-01702-w
    1. Coelho E. B. S., Bolsoni C. C., Warmling D., Conceição T. B., de Campos D. A. (2020). in Orientações sobre a COVID-19 na Atenção Especializada. Editors Conceição T. B., Bolsoni C. C., Warmling D., de Campos D. A. (Florianópolis: Secretaria de Gestão do Trabalho e da Educação na Saúde - SGTES; ).
    1. Crook H., Raza S., Nowell J., Young M., Edison P. (2021). Long Covid-Mechanisms, Risk Factors, and Management. Bmj 374, n1648. 10.1136/bmj.n1648
    1. Daher A., Balfanz P., Cornelissen C., Müller A., Bergs I., Marx N., et al. (2020). Follow up of Patients with Severe Coronavirus Disease 2019 (COVID-19): Pulmonary and Extrapulmonary Disease Sequelae. Respir. Med. 174, 106197. 10.1016/j.rmed.2020.106197
    1. Davis H. E., Assaf G. S., McCorkell L., Wei H., Low R. J., Re'em Y., et al. (2021). Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact. EClinicalMedicine 38, 101019. 10.1016/j.eclinm.2021.101019
    1. De Rosa A., Verrengia E. P., Merlo I., Rea F., Siciliano G., Corrao G., et al. (2021). Muscle Manifestations and CK Levels in COVID Infection: Results of a Large Cohort of Patients inside a Pandemic COVID-19 Area. Acta Myol 40, 1–7. 10.1016/j.jns.2021.119838
    1. de Souza W. M., Buss L. F., Candido D. d. S., Carrera J.-P., Li S., Zarebski A. E., et al. (2020). Epidemiological and Clinical Characteristics of the COVID-19 Epidemic in Brazil. Nat. Hum. Behav. 4, 856–865. 10.1038/s41562-020-0928-4
    1. Desdouits M., Munier S., Prevost M.-C., Jeannin P., Butler-Browne G., Ozden S., et al. (2013). Productive Infection of Human Skeletal Muscle Cells by Pandemic and Seasonal Influenza A(H1N1) Viruses. PLoS One 8, e79628. 10.1371/journal.pone.0079628
    1. Disser N. P., De Micheli A. J., Schonk M. M., Konnaris M. A., Piacentini A. N., Edon D. L., et al. (2020). Musculoskeletal Consequences of COVID-19. J. Bone Jt. Surg. Am. 102, 1197–1204. 10.2106/JBJS.20.00847
    1. do Nascimento I. J. B., Cacic N., Abdulazeem H. M., von Groote T. C., Jayarajah U., Weerasekara I., et al. (2020). Novel Coronavirus Infection (COVID-19) in Humans: A Scoping Review and Meta-Analysis. J. Clin. Med. 9, 1–14. 10.3390/jcm9040941
    1. Drożdżal S., Rosik J., Lechowicz K., Machaj F., Szostak B., Majewski P., et al. (2020). COVID-19: Pain Management in Patients with SARS-CoV-2 Infection-Molecular Mechanisms, Challenges, and Perspectives. Brain Sci. 10, 465. 10.3390/brainsci10070465
    1. Elhiny R., Al-jumaili A. A., Yawuz M. J. (2021). What Might COVID-19 Patients Experience after Recovery? A Systematic Review. Int. J. Clin. Pract. 2021, 1–18. 10.22541/au.162392727.73465025/v1
    1. Fang H., Wegman A. D., Ripich K., Friberg H., Currier J. R., Thomas S. J., et al. (2021). Persistent COVID-19 Symptoms Minimally Impact the Development of SARS-CoV-2-specific T Cell Immunity. Viruses 13, 916. 10.3390/v13050916
    1. Feng Y., Ling Y., Bai T., Xie Y., Huang J., Li J., et al. (2020). COVID-19 with Different Severities: A Multicenter Study of Clinical Features. Am. J. Respir. Crit. Care Med. 201, 1380–1388. 10.1164/rccm.202002-0445OC
    1. Fernandes T., Hashimoto N. Y., Oliveira E. M. (2010). Characterization of Angiotensin-Converting Enzymes 1 and 2 in the Soleus and Plantaris Muscles of Rats. Braz. J. Med. Biol. Res. 43, 837–842. 10.1590/S0100-879X2010007500088
    1. Fernández-de-las-Peñas C., Palacios-Ceña D., Gómez-Mayordomo V., Cuadrado M. L., Florencio L. L. (2021). Defining Post-COVID Symptoms (Post-Acute COVID, Long COVID, Persistent Post-COVID): An Integrative Classification. Int. J. Environ. Res. Public Health 18, 2621. 10.3390/ijerph18052621
    1. Ferrandi P. J., Alway S. E., Mohamed J. S. (2020). The Interaction between SARS-CoV-2 and ACE2 May Have Consequences for Skeletal Muscle Viral Susceptibility and Myopathies. J. Appl. Physiol. 129, 864–867. 10.1152/japplphysiol.00321.2020
    1. Fitts R. H. (2004). “Mechanisms of Muscular Fatigue,” in Principles of Exercise Biochemistry. Editor Poortmans J. R. (Switzerland: Karger Medical and Scientific Publishers; ), 306.
    1. Fotuhi M., Mian A., Meysami S., Raji C. A. (2020). Neurobiology of COVID-19. Jad 76, 3–19. 10.3233/JAD-200581
    1. Frontera W. R., Ochala J. (2015). Skeletal Muscle: A Brief Review of Structure and Function. Calcif Tissue Int. 96, 183–195. 10.1007/s00223-014-9915-y
    1. Gavriatopoulou M., Korompoki E., Fotiou D., Ntanasis-Stathopoulos I., Psaltopoulou T., Kastritis E., et al. (2020). Organ-specific Manifestations of COVID-19 Infection. Clin. Exp. Med. 20, 493–506. 10.1007/s10238-020-00648-x
    1. Ghayda R. A., Lee J., Lee J. Y., Kim D. K., Lee K. H., Hong S. H., et al. (2020). Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis. Ijerph 17, 5026. 10.3390/ijerph17145026
    1. Ghosn J., Piroth L., Epaulard O., Le Turnier P., Mentré F., Bachelet D., et al. (2021). Persistent COVID-19 Symptoms Are Highly Prevalent 6 Months after Hospitalization: Results from a Large Prospective Cohort. Clin. Microbiol. Infect. 27, 1041.e1–1041.e4. 10.1016/j.cmi.2021.03.012
    1. Giannoglou G. D., Chatzizisis Y. S., Misirli G. (2007). The Syndrome of Rhabdomyolysis: Pathophysiology and Diagnosis. Eur. J. Intern. Med. 18, 90–100. 10.1016/j.ejim.2006.09.020
    1. Giraudo C., Librizzi G., Fichera G., Motta R., Balestro E., Calabrese F., et al. (2021). Reduced Muscle Mass as Predictor of Intensive Care Unit Hospitalization in COVID-19 Patients. PLoS One 16, e0253433. 10.1371/journal.pone.0253433
    1. Goërtz Y. M. J., Van Herck M., Delbressine J. M., Vaes A. W., Meys R., Machado F. V. C., et al. (2020). Persistent Symptoms 3 Months after a SARS-CoV-2 Infection: the post-COVID-19 Syndrome? ERJ Open Res. 6, 00542–02020. 10.1183/23120541.00542-2020
    1. Gonzalez A., Orozco-Aguilar J., Achiardi O., Simon F., Cabello-Verrugio C. (2020). SARS-CoV-2/Renin-Angiotensin System: Deciphering the Clues for a Couple with Potentially Harmful Effects on Skeletal Muscle. Int. J. Mol. Sci. 21, 7904. 10.3390/ijms21217904
    1. Graham E. L., Clark J. R., Orban Z. S., Lim P. H., Szymanski A. L., Taylor C., et al. (2021). Persistent Neurologic Symptoms and Cognitive Dysfunction in Non‐hospitalized Covid‐19 "long Haulers". Ann. Clin. Transl. Neurol. 8, 1073–1085. 10.1002/acn3.51350
    1. Gupta A., Madhavan M. V., Sehgal K., Nair N., Mahajan S., Sehrawat T. S., et al. (2020). Extrapulmonary Manifestations of COVID-19. Nat. Med. 26, 1017–1032. 10.1038/s41591-020-0968-3
    1. Halpin S. J., McIvor C., Whyatt G., Adams A., Harvey O., McLean L., et al. (2021). Postdischarge Symptoms and Rehabilitation Needs in Survivors of COVID‐19 Infection: A Cross‐sectional Evaluation. J. Med. Virol. 93, 1013–1022. 10.1002/jmv.26368
    1. Harapan B. N., Yoo H. J. (2021). Neurological Symptoms, Manifestations, and Complications Associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Coronavirus Disease 19 (COVID-19). J. Neurol. 2, 1–13. 10.1007/s00415-021-10406-y
    1. Haroun M. W., Dieiev V., Kang J., Barbi M., Marashi Nia S. F., Gabr M., et al. (2021). Rhabdomyolysis in COVID-19 Patients: A Retrospective Observational Study. Cureus 13, e12552. 10.7759/cureus.12552
    1. Henderson L. A., Canna S. W., Schulert G. S., Volpi S., Lee P. Y., Kernan K. F., et al. (2020). On the Alert for Cytokine Storm: Immunopathology in COVID ‐19. Arthritis Rheumatol. 72, 1059–1063. 10.1002/art.41285
    1. Hoffer E. P. (2021). Long Covid: Does it Exist? what Is it? We Can We Do for Sufferers? Am. J. Med. 134, 1310–1311. In press. 10.1016/j.amjmed.2021.05.023
    1. Hooper J. E., Uner M., Priemer D. S., Rosenberg A., Chen L. (2021). Muscle Biopsy Findings in a Case of SARS-CoV-2-Associated Muscle Injury. J. Neuropathol. Exp. Neurol. 80, 377–378. 10.1093/jnen/nlaa155
    1. Huang C., Huang L., Wang Y., Li X., Ren L., Gu X., et al. (2020). 6-month Consequences of COVID-19 in Patients Discharged from Hospital: a Cohort Study. Lancet 397, 19–21.
    1. Humphreys H., Kilby L., Kudiersky N., Copeland R. (2021). Long COVID and the Role of Physical Activity: a Qualitative Study. BMJ Open 11, e047632. 10.1136/bmjopen-2020-047632
    1. Husain R., Corcuera-Solano I., Dayan E., Jacobi A. H., Huang M. (2020). Rhabdomyolysis as a Manifestation of a Severe Case of COVID-19: A Case Report. Radiol. Case Rep. 15, 1633–1637. 10.1016/j.radcr.2020.07.003
    1. Islam B., Ahmed M., Islam Z., Begum S. M. (2021). Severe Acute Myopathy Following SARS-CoV-2 Infection: a Case Report and Review of Recent Literature. Skeletal Muscle 11, 1–7. 10.1186/s13395-021-00266-5
    1. Jacobs L. G., Gourna Paleoudis E., Lesky-Di Bari D., Nyirenda T., Friedman T., Gupta A., et al. (2020). Persistence of Symptoms and Quality of Life at 35 Days after Hospitalization for COVID-19 Infection. PLoS One 15, e0243882. 10.1371/journal.pone.0243882
    1. Ji H.-L., Zhao R., Matalon S., Matthay M. A. (2020). Elevated Plasmin(ogen) as a Common Risk Factor for COVID-19 Susceptibility. Physiol. Rev. 100, 1065–1075. 10.1152/physrev.00013.2020
    1. Kamal M., Abo Omirah M., Hussein A., Saeed H. (2021). Assessment and Characterisation of post‐COVID‐19 Manifestations. Int. J. Clin. Pract. 75, e13746. 10.1111/ijcp.13746
    1. Kanmaniraja D., Le J., Hsu K., Lee J. S., Mcclelland A., Slasky S. E., et al. (2021). Review of COVID-19, Part 2: Musculoskeletal and Neuroimaging Manifestations Including Vascular Involvement of the Aorta and Extremities. Clin. Imaging 79, 300–313. 10.1016/j.clinimag.2021.08.003
    1. Karadaş Ö., Öztürk B., Sonkaya A. R. (2020). A Prospective Clinical Study of Detailed Neurological Manifestations in Patients with COVID-19. Neurol. Sci. 41, 1991–1995. 10.1007/s10072-020-04547-7
    1. Kerkman J. N., Daffertshofer A., Gollo L. L., Breakspear M., Boonstra T. W. (2018). Network Structure of the Human Musculoskeletal System Shapes Neural Interactions on Multiple Time Scales. Sci. Adv. 4, eaat0497. 10.1126/sciadv.aat0497
    1. Khadilkar S., Benny R. (2020). COVID 19: Neuromuscular Manifestations. Ann. Indian Acad. Neurol. 23, S40–S42. 10.4103/aian.AIAN_309_20
    1. Khamis A. H., Jaber M., Azar A., AlQahtani F., Bishawi K., Shanably A. (2021). Clinical and Laboratory Findings of COVID-19: A Systematic Review and Meta-Analysis. J. Formos. Med. Assoc. 120, 1706–1718. 10.1016/j.jfma.2020.12.003
    1. Khan A. R., Farooqui M. O., Jatoi N. N., Jawaid S., Mahdi D., Khosa F. (2020). Neurological Manifestations of SARS-CoV-2. Neurologist 26, 15–19. 10.1097/NRL.0000000000000307
    1. Khosla S. G., Nylen E. S., Khosla R. (2020). Rhabdomyolysis in Patients Hospitalized with COVID-19 Infection: Five Case Series. J. Invest. Med. High Impact Case Rep. 8, 232470962098460. 10.1177/2324709620984603
    1. Kim G.-u., Kim M.-J., Ra S. H., Lee J., Bae S., Jung J., et al. (2020). Clinical Characteristics of Asymptomatic and Symptomatic Patients with Mild COVID-19. Clin. Microbiol. Infect. 26, 948.e1–948.e3. 10.1016/j.cmi.2020.04.040
    1. Knight D., Downes K., Munipalli B., Halkar M. G., Logvinov I. I., Speicher L. L., et al. (2021). Symptoms and Clinical Outcomes of Coronavirus Disease 2019 in the Outpatient Setting. SN Compr. Clin. Med. 3, 247–254. 10.1007/s42399-021-00746-1
    1. Kordzadeh-Kermani E., Khalili H., Karimzadeh I. (2020). Pathogenesis, Clinical Manifestations and Complications of Coronavirus Disease 2019 (COVID-19). Future Microbiol. 15, 1287–1305. 10.2217/fmb-2020-0110
    1. Kumar A., Kumar A., Kumar N., Kumar A., Sinha C., Kumari P., et al. (2021). Monitoring and Evaluation of Muscle Atrophy: a Much Needed Step in Critically Ill COVID-19 Patients. Crit. Care Innov. 4, 30–43. 10.32114/CCI.2021.4.1.30.43
    1. Lad H., Saumur T. M., Herridge M. S., Dos Santos C. C., Mathur S., Batt J., et al. (2020). Intensive Care Unit-Acquired Weakness: Not Just Another Muscle Atrophying Condition. Int. J. Mol. Sci. 21, 7840. 10.3390/ijms21217840
    1. Lechien J. R., Chiesa‐Estomba C. M., Place S., Van Laethem Y., Cabaraux P., Mat Q., et al. (2020). Clinical and Epidemiological Characteristics of 1420 European Patients with Mild‐to‐moderate Coronavirus Disease 2019. J. Intern. Med. 288, 335–344. 10.1111/joim.13089
    1. Leth S., Gunst J. D., Mathiasen V., Hansen K., Søgaard O., Østergaard L., et al. (2021). Persistent Symptoms in Patients Recovering from COVID-19 in Denmark. Open Forum Infect. Dis. 8, 1–7. 10.1093/ofid/ofab042
    1. Leviner S. (2021). Recognizing the Clinical Sequelae of COVID-19 in Adults: COVID-19 Long-Haulers. J. Nurse Pract. 17, 946–949. 10.1016/j.nurpra.2021.05.003
    1. Li W., Moylan J. S., Chambers M. A., Smith J., Reid M. B. (2009). Interleukin-1 Stimulates Catabolism in C2C12 Myotubes. Am. J. Physiology-Cell Physiol. 297, C706–C714. 10.1152/ajpcell.00626.2008
    1. Liang L., Yang B., Jiang N., Fu W., He X., Zhou Y., et al. (2020). Three-month Follow-Up Study of Survivors of Coronavirus Disease 2019 after Discharge. J. Korean Med. Sci. 35, e418. 10.3346/JKMS.2020.35.E418
    1. Logue J. K., Franko N. M., McCulloch D. J., McDonald D., Magedson A., Wolf C. R., et al. (2021). Sequelae in Adults at 6 Months after COVID-19 Infection. JAMA Netw. Open 4, e210830. 10.1001/jamanetworkopen.2021.0830
    1. Lu L., Zhong W., Bian Z., Li Z., Zhang K., Liang B., et al. (2020). A Comparison of Mortality-Related Risk Factors of COVID-19, SARS, and MERS: A Systematic Review and Meta-Analysis. J. Infect. 81, e18–e25. 10.1016/j.jinf.2020.07.002
    1. Machhi J., Herskovitz J., Senan A. M., Dutta D., Nath B., Oleynikov M. D., et al. (2020). The Natural History, Pathobiology, and Clinical Manifestations of SARS-CoV-2 Infections. J. Neuroimmune Pharmacol. 15, 359–386. 10.1007/s11481-020-09944-5
    1. Mageriu V., Zurac S., Bastian A., Staniceanu F., Manole E. (2020). Histological Findings in Skeletal Muscle of SARS-CoV2 Infected Patient. J. Immunoassay Immunochemistry 41, 1000–1009. 10.1080/15321819.2020.1863819
    1. Mah T. J., Lum Y. H., Fan B. E. (2021). Coronavirus Disease 2019 Presenting with Rhabdomyolysis. Proc. Singapore Healthc. 30, 68–70. 10.1177/2010105820943911
    1. Mahmud R., Rahman M. M., Rassel M. A., Monayem F. B., Sayeed S. K. J. B., Islam M. S., et al. (2021). Post-COVID-19 Syndrome Among Symptomatic COVID-19 Patients: A Prospective Cohort Study in a Tertiary Care center of Bangladesh. PLoS One 16, e0249644. 10.1371/journal.pone.0249644
    1. Marshall M. (2021). The Four Most Urgent Questions about Long COVID. Nature 594, 168–170. 10.1038/d41586-021-01511-z
    1. Meegada S., Muppidi V., Wilkinson D. C., Siddamreddy S., Katta S. K. (2020). Coronavirus Disease 2019-Induced Rhabdomyolysis. Cureus 12, e10123. 10.7759/cureus.10123
    1. Mehta O. P., Bhandari P., Raut A., Kacimi S. E. O., Huy N. T. (2021). Coronavirus Disease (COVID-19): Comprehensive Review of Clinical Presentation. Front. Public Health 8, 1–9. 10.3389/fpubh.2020.582932
    1. Meng Z., Guo S., Zhou Y., Li M., Wang M., Ying B. (2021). Applications of Laboratory Findings in the Prevention, Diagnosis, Treatment, and Monitoring of COVID-19. Sig Transduct Target. Ther. 6, 316. 10.1038/s41392-021-00731-z
    1. Mense S. (2003). The Pathogenesis of Muscle Pain. Curr. Sci. Inc 7, 419–425. 10.1007/s11916-003-0057-6
    1. Meyer-Frießem C. H., Gierthmühlen J., Baron R., Sommer C., Üçeyler N., Enax-Krumova E. K. (2021). Pain during and after COVID-19 in Germany and Worldwide: A Narrative Review of Current Knowledge. Pr9 6, e893. 10.1097/PR9.0000000000000893
    1. Miyazato Y., Morioka S., Tsuzuki S., Akashi M., Osanai Y., Tanaka K., et al. (2020). Prolonged and Late-Onset Symptoms of Coronavirus Disease 2019. Open Forum Infect. Dis. 7, 1–3. 10.1093/ofid/ofaa507
    1. Moghimi N., Di Napoli M., Biller J., Siegler J. E., Shekhar R., McCullough L. D., et al. (2021). The Neurological Manifestations of Post-Acute Sequelae of SARS-CoV-2 Infection. Curr. Neurol. Neurosci. Rep. 21, 1–17. 10.1007/s11910-021-01130-1
    1. Moreno-Pérez O., Merino E., Leon-Ramirez J.-M., Andres M., Ramos J. M., Arenas-Jiménez J., et al. (2021). Post-acute COVID-19 Syndrome. Incidence and Risk Factors: A Mediterranean Cohort Study. J. Infect. 82, 378–383. 10.1016/j.jinf.2021.01.004
    1. Morley J. E., Kalantar‐Zadeh K., Anker S. D. (2020). COVID‐19: a Major Cause of Cachexia and Sarcopenia? J. Cachexia, Sarcopenia Muscle 11, 863–865. 10.1002/jcsm.12589
    1. Motta-Santos D., Dos Santos R. A. S., Oliveira M., Qadri F., Poglitsch M., Mosienko V., et al. (2016). Effects of ACE2 Deficiency on Physical Performance and Physiological Adaptations of Cardiac and Skeletal Muscle to Exercise. Hypertens. Res. 39, 506–512. 10.1038/hr.2016.28
    1. Mughal M. S., Kaur I. P., Alhashemi R., Rehman R., Du D. (2021). Acute Viral Myositis Complicated by Rhabdomyolysis: a Sole Manifestation of COVID-19 Infection. J. Community Hosp. Intern. Med. Perspect. 11, 289–291. 10.1080/20009666.2021.1878601
    1. Mukherjee A., Ghosh R., Aftab G. (2020). Rhabdomyolysis in a Patient with Coronavirus Disease 2019. Cureus 2, e8956. 10.7759/cureus.8956
    1. Mukund K., Subramaniam S. (2020). Skeletal Muscle: A Review of Molecular Structure and Function, in Health and Disease. Wires Syst. Biol. Med. 12, e1462. 10.1002/wsbm.1462
    1. National Institute for Health and Care Excellence (2020). COVID-19 Rapid Guideline: Managing the Long-Term Effects of COVID-19. London, UK: NICE Guidel, 1–35. Available at: .
    1. National Institutes of Health (2021). COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Bethesda, Maryland: NIH 2019, 1–358. Available at: .
    1. Nepal G., Rehrig J. H., Shrestha G. S., Shing Y. K., Yadav J. K., Ojha R., et al. (2020). Neurological Manifestations of COVID-19: a Systematic Review. Crit. Care 24, 421. 10.1186/s13054-020-03121-z
    1. Orsucci D. (2020). Is Creatine Kinase Associated with Outcome in COVID-19? Nn 2020, 1–6. 10.20517/2347-8659.2020.53
    1. Orsucci D., Trezzi M., Anichini R., Blanc P., Barontini L., Biagini C., et al. (2021). Increased Creatine Kinase May Predict A Worse COVID-19 Outcome. J. Clin. Med. 10, 1734. 10.3390/jcm10081734
    1. Pajak B., Orzechowska S., Pijet B., Pijet M., Pogorzelska A., Gajkowska B., et al. (2008). Crossroads of Cytokine Signaling-Tthe chase to Stop Muscle Cachexia. J. Physiol. Pharmacol. 59 (Suppl. 9), 251–264. 10.1177/1461444810365020
    1. Paliwal V. K., Garg R. K., Gupta A., Tejan N. (2020). Neuromuscular Presentations in Patients with COVID-19. Neurol. Sci. 41, 3039–3056. 10.1007/s10072-020-04708-8
    1. Pan American Health Organization (2021). COVID-19 Timeline. Washington, DC: PAHO/WHO, 1–3. Available at: (Accessed September 2, 2021).
    1. Paneroni M., Simonelli C., Saleri M., Bertacchini L., Venturelli M., Troosters T., et al. (2021). Muscle Strength and Physical Performance in Patients without Previous Disabilities Recovering from COVID-19 Pneumonia. Am. J. Phys. Med. Rehabil. 100, 105–109. 10.1097/PHM.0000000000001641
    1. Partridge L. J., Urwin L., Nicklin M. J. H., James D. C., Green L. R., Monk P. N. (2021). ACE2-Independent Interaction of SARS-CoV-2 Spike Protein with Human Epithelial Cells Is Inhibited by Unfractionated Heparin. Cells 10, 1419. 10.3390/cells10061419
    1. Patel V., Alzghoul B., Kalra S. S. (2021). COVID-19 Infection and Severe Rhabdomyolysis. Baylor Univ. Med. Cent. Proc. 34, 478–480. 10.1080/08998280.2021.1897341
    1. Peghin M., Palese A., Venturini M., De Martino M., Gerussi V., Graziano E., et al. (2021). Post-COVID-19 Symptoms 6 Months after Acute Infection Among Hospitalized and Non-hospitalized Patients. Clin. Microbiol. Infect. 27, 1507–1513. 10.1016/j.cmi.2021.05.033
    1. Pelosi M., De Rossi M., Barberi L., Musarò A. (2014). IL-6 Impairs Myogenic Differentiation by Downmodulation of p90RSK/eEF2 and mTOR/p70S6K Axes, without Affecting AKT Activity. Biomed. Res. Int. 2014, 12–13. 10.1155/2014/206026
    1. Petersen M. S., Kristiansen M. F., Hanusson K. D., Danielsen M. E., á Steig B., Gaini S., et al. (2020). Long COVID in the Faroe Islands: A Longitudinal Study Among Nonhospitalized Patients. Clin. Infect. Dis. 73, e4058–e4063. In press. 10.1093/cid/ciaa1792
    1. Pinzon R. T., Wijaya V. O., Buana R. B., Al Jody A., Nunsio P. N. (2020). Neurologic Characteristics in Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis. Front. Neurol. 11, 565. 10.3389/fneur.2020.00565
    1. Pitscheider L., Karolyi M., Burkert F. R., Helbok R., Wanschitz J. V., Horlings C., et al. (2021). Muscle Involvement in SARS‐CoV‐2 Infection. Eur. J. Neurol. 28, 3411–3417. 10.1111/ene.14564
    1. Ponti G., Maccaferri M., Ruini C., Tomasi A., Ozben T. (2020). Biomarkers Associated with COVID-19 Disease Progression. Crit. Rev. Clin. Lab. Sci. 57, 389–399. 10.1080/10408363.2020.1770685
    1. Puccioni-Sohler M., Poton A. R., Franklin M., Silva S. J. d., Brindeiro R., Tanuri A. (2020). Current Evidence of Neurological Features, Diagnosis, and Neuropathogenesis Associated with COVID-19. Rev. Soc. Bras. Med. Trop. 53, e20200477. 10.1590/0037-8682-0477-2020
    1. Quraishi F. A., Rahman A., Twinkle F. Q. (2021). Spectrum of Neurological Manifestations in COVID-19: A Review. Bangla J. Med. 32, 120–137. 10.3329/bjm.v32i2.53790
    1. Ragab D., Salah Eldin H., Taeimah M., Khattab R., Salem R. (2020). The COVID-19 Cytokine Storm; what We Know So Far. Front. Immunol. 11, 1–4. 10.3389/fimmu.2020.01446
    1. Ramani S. L., Samet J., Franz C. K., Hsieh C., Nguyen C. V., Horbinski C., et al. (2021). Musculoskeletal Involvement of COVID-19: Review of Imaging. Skeletal Radiol. 50, 1763–1773. 10.1007/s00256-021-03734-7
    1. Ramos-Casals M., Brito-Zerón P., Mariette X. (2021). Systemic and Organ-specific Immune-Related Manifestations of COVID-19. Nat. Rev. Rheumatol. 17, 315–332. 10.1038/s41584-021-00608-z
    1. Rayavarapu S., Coley W., Kinder T. B., Nagaraju K. (2013). Idiopathic Inflammatory Myopathies: Pathogenic Mechanisms of Muscle Weakness. Skeletal Muscle 3, 1–13. 10.1186/2044-5040-3-13
    1. Revzin M. V., Raza S., Srivastava N. C., Warshawsky R., D’Agostino C., Malhotra A., et al. (2020). Multisystem Imaging Manifestations of COVID-19, Part 2: From Cardiac Complications to Pediatric Manifestations. Radiographics 40, 1866–1892. 10.1148/rg.2020200195
    1. Riquelme C., Acuña M. J., Torrejón J., Rebolledo D., Cabrera D., Santos R. A., et al. (2014). ACE2 Is Augmented in Dystrophic Skeletal Muscle and Plays a Role in Decreasing Associated Fibrosis. PLoS One 9, e93449. 10.1371/journal.pone.0093449
    1. Rivas-García S., Bernal J., Bachiller-Corral J. (2020). Rhabdomyolysis as the Main Manifestation of Coronavirus Disease 2019. Rheumatol. (United Kingdom) 59, 2174–2176. 10.1093/rheumatology/keaa351
    1. Romagnoli S., Peris A., De Gaudio A. R., Geppetti P. (2020). SARS-CoV-2 and COVID-19: From the Bench to the Bedside. Physiol. Rev. 100, 1455–1466. 10.1152/physrev.00020.2020
    1. Rosato C., Bolondi G., Russo E., Oliva A., Scognamiglio G., Mambelli E., et al. (2020). Clinical, Electromyographical, Histopathological Characteristics of COVID-19 Related Rhabdomyolysis. SAGE Open Med. Case Rep. 8, 2050313X2098313–4. 10.1177/2050313x20983132
    1. Rossi G. A., Sacco O., Mancino E., Cristiani L., Midulla F. (2020). Differences and Similarities between SARS-CoV and SARS-CoV-2: Spike Receptor-Binding Domain Recognition and Host Cell Infection with Support of Cellular Serine Proteases. Infection 48, 665–669. 10.1007/s15010-020-01486-5
    1. Rudroff T., Fietsam A. C., Deters J. R., Bryant A. D., Kamholz J. (2020). Post-COVID-19 Fatigue: Potential Contributing Factors. Brain Sci. 10, 1012–1017. 10.3390/brainsci10121012
    1. Sagarra-Romero L., Viñas-Barros A. (2020). COVID-19: Short and Long-Term Effects of Hospitalization on Muscular Weakness in the Elderly. Int. J. Environ. Res. Public Health 17, 8715. 10.3390/ijerph17238715
    1. Salamanna F., Veronesi F., Martini L., Landini M. P., Fini M. (2021). Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data. Front. Med. 8, 653516. 10.3389/fmed.2021.653516
    1. Santilli N., Bomgaars D. L., Sukumaran S., Levy S. B. (2020). Activities of Daily Living. Treasure Island, FL: StatPearls Publishing, 539–544. 10.1201/9781003066736-72
    1. Sarkesh A., Daei Sorkhabi A., Sheykhsaran E., Alinezhad F., Mohammadzadeh N., Hemmat N., et al. (2020). Extrapulmonary Clinical Manifestations in COVID-19 Patients. Am. J. Trop. Med. Hyg. 103, 1783–1796. 10.4269/ajtmh.20-0986
    1. Saud A., Naveen R., Aggarwal R., Gupta L. (2021). COVID-19 and Myositis: What We Know So Far. Curr. Rheumatol. Rep. 23, 63. 10.1007/s11926-021-01023-9
    1. Seth A., Hicks J. L., Uchida T. K., Habib A., Dembia C. L., Dunne J. J., et al. (2018). OpenSim: Simulating Musculoskeletal Dynamics and Neuromuscular Control to Study Human and Animal Movement. Plos Comput. Biol. 14, e1006223. 10.1371/journal.pcbi.1006223
    1. Shendy W., Ezzat M. M., ELaidy D. A., Elsherif A. A. (2021). Prevalence of Fatigue in Patients post Covid-19. Eur. J. Mol. Clin. Med. 8, 1330–1340. Available at: .
    1. Sheraton M., Deo N., Kashyap R., Surani S. (2020). A Review of Neurological Complications of COVID-19. Cureus 2, e8192. 10.7759/cureus.8192
    1. Singh A., Zaheer S., Kumar N., Singla T., Ranga S. (2021). Covid19, beyond Just the Lungs: A Review of Multisystemic Involvement by Covid19. Pathol. - Res. Pract. 224, 153384. 10.1016/j.prp.2021.153384
    1. Singh B., Kaur P., Mechineni A., Maroules M. (2020). Rhabdomyolysis in COVID-19: Report of Four Cases. Cureus 12, e10686. 10.7759/cureus.10686
    1. Sivan M., Taylor S. (2020). NICE Guideline on Long Covid. BMJ 371, m4938. 10.1136/bmj.m4938
    1. Small C. N., Beatty N. L. (2020). Atypical Features of COVID-19: A Literature Review. Jcom 27, 131–134. 10.12788/jcom.0005
    1. Solís J. G., Esquivel Pineda A., Alberti Minutti P., Albarrán Sánchez A. (2020). Case Report: Rhabdomyolysis in a Patient with COVID-19: A Proposed Diagnostic-Therapeutic Algorithm. Am. J. Trop. Med. Hyg. 103, 1158–1161. 10.4269/ajtmh.20-0692
    1. Stahl K., Rastelli E., Schoser B. (2020). A Systematic Review on the Definition of Rhabdomyolysis. J. Neurol. 267, 877–882. 10.1007/s00415-019-09185-4
    1. Stavem K., Ghanima W., Olsen M. K., Gilboe H. M., Einvik G. (2021). Persistent Symptoms 1.5-6 Months after COVID-19 in Non-hospitalised Subjects: A Population-Based Cohort Study. Thorax 76, 405–407. 10.1136/thoraxjnl-2020-216377
    1. Sudre C. H., Murray B., Varsavsky T., Graham M. S., Penfold R. S., Bowyer R. C., et al. (2021). Attributes and Predictors of Long COVID. Nat. Med. 27, 626–631. 10.1038/s41591-021-01292-y
    1. Suh J., Mukerji S. S., Collens S. I., Padera R. F., Pinkus G. S., Amato A. A., et al. (2021). Skeletal Muscle and Peripheral Nerve Histopathology in COVID-19. Neurology 97, e849–e858. 10.1212/wnl.0000000000012344
    1. Sykes D. L., Holdsworth L., Jawad N., Gunasekera P., Morice A. H., Crooks M. G. (2021). Post-COVID-19 Symptom Burden: What Is Long-COVID and How Should We Manage it? Lung 199, 113–119. 10.1007/s00408-021-00423-z
    1. Taga G. (1995). A Model of the Neuro-Musculo-Skeletal System for Human Locomotion. Biol. Cybern. 73, 97–111. 10.1007/BF00204048
    1. Takeda M., Yamamoto K., Takemura Y., Takeshita H., Hongyo K., Kawai T., et al. (2013). Loss of ACE2 Exaggerates High-Calorie Diet-Induced Insulin Resistance by Reduction of GLUT4 in Mice. Diabetes 62, 223–233. 10.2337/db12-0177
    1. Tang D., Comish P., Kang R. (2020). The Hallmarks of COVID-19 Disease. Plos Pathog. 16, e1008536. 10.1371/journal.ppat.1008536
    1. Tay M. Z., Poh C. M., Rénia L., MacAry P. A., Ng L. F. P. (2020). The trinity of COVID-19: Immunity, Inflammation and Intervention. Nat. Rev. Immunol. 20, 363–374. 10.1038/s41577-020-0311-8
    1. Tenforde M. W., Kim S. S., Lindsell C. J., Billig Rose E., Shapiro N. I., Files D. C., et al. (2020). Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network - United States, March-June 2020. MMWR Morb. Mortal. Wkly. Rep. 69, 993–998. 10.15585/mmwr.mm6930e1
    1. Trovato F., Imbesi R., Conway N., Castrogiovanni P. (2016). Morphological and Functional Aspects of Human Skeletal Muscle. J. Funct. Morphol. Kinesiol. 1, 289–302. 10.3390/jfmk1030289
    1. Tseng Y.-H., Chen T.-H. (2021). Care for Patients with Neuromuscular Disorders in the COVID-19 Pandemic Era. Front. Neurol. 12, 607790. 10.3389/fneur.2021.607790
    1. Tu H., Tu S., Gao S., Shao A., Sheng J. (2020). Current Epidemiological and Clinical Features of COVID-19; a Global Perspective from China. J. Infect. 81, 1–9. 10.1016/j.jinf.2020.04.011
    1. Ucaroglu N., Kaya Ö., Kotan D. (2020). Myalgia Frequency in Patients with COVID-19 and its Relationship with Creatine Kinase Levels. Duzce Med. J. 22, 34–38. 10.18678/dtfd.776953
    1. VanderVeen B. N., Fix D. K., Montalvo R. N., Counts B. R., Smuder A. J., Murphy E. A., et al. (2019). The Regulation of Skeletal Muscle Fatigability and Mitochondrial Function by Chronically Elevated Interleukin-6. Exp. Physiol. 104, 385–397. 10.1113/EP087429
    1. Vanichkachorn G., Newcomb R., Cowl C. T., Murad M. H., Breeher L., Miller S., et al. (2021). Post-COVID-19 Syndrome (Long Haul Syndrome): Description of a Multidisciplinary Clinic at Mayo Clinic and Characteristics of the Initial Patient Cohort. Mayo Clinic Proc. 96, 1782–1791. 10.1016/j.mayocp.2021.04.024
    1. Varghese J., Sandmann S., Ochs K., Schrempf I.-M., Frömmel C., Dugas M., et al. (2021). Persistent Symptoms and Lab Abnormalities in Patients Who Recovered from COVID-19. Sci. Rep. 11, 12775. 10.1038/s41598-021-91270-8
    1. Vasiliadis A. V., Tsatlidou M., Metaxiotis D., Psomiadis C., Beletsiotis A., Arvaniti K. (2021). Non-Respiratory Symptoms of Patients Infected with SARS-CoV-2 (Coronavirus Disease 2019): Lessons from Their Initial Presentation at the Hospital. Medicina 57, 344–348. 10.3390/medicina57040344
    1. Wang X., Fang J., Zhu Y., Chen L., Ding F., Zhou R., et al. (2020). Clinical Characteristics of Non-critically Ill Patients with Novel Coronavirus Infection (COVID-19) in a Fangcang Hospital. Clin. Microbiol. Infect. 26, 1063–1068. 10.1016/j.cmi.2020.03.032
    1. Wasserman P. L., Way A., Baig S., Gopireddy D. R. (2021). MRI of Myositis and Other Urgent Muscle-Related Disorders. Emerg. Radiol. 28, 409–421. 10.1007/s10140-020-01866-2
    1. White-Dzuro G., Gibson L. E., Zazzeron L., White-Dzuro C., Sullivan Z., Diiorio D. A., et al. (2021). Multisystem Effects of COVID-19: a Concise Review for Practitioners. Postgrad. Med. 133, 20–27. 10.1080/00325481.2020.1823094
    1. World Health Organization (2021c). Clinical Management of COVID-19: Living Guidance. Geneva, Switzerland: WHO, 1–81. Available at: .
    1. World Health Organization (2021d). Coronavirus Disease (COVID-19). Geneva, Switzerland: WHO, 1–6. 10.1007/978-3-319-95714-2_300044
    1. World Health Organization (2021a). Timeline: WHO’s COVID-19 Response. Geneva, Switzerland: WHO, 1–3. Available at: (Accessed September 2, 2021).
    1. World Health Organization (2021b). WHO Coronavirus (COVID-19) Dashboard. Geneva, Switzerland: WHO, 1–5. Available at: (Accessed August 23, 2021).
    1. Wu Z., McGoogan J. M. (2020). Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China. JAMA 323, 1239–1242. 10.1001/jama.2020.2648
    1. Xie J., Wang Q., Xu Y., Zhang T., Chen L., Zuo X., et al. (2021). Clinical Characteristics, Laboratory Abnormalities and CT Findings of COVID-19 Patients and Risk Factors of Severe Disease: a Systematic Review and Meta-Analysis. Ann. Palliat. Med. 10, 1928–1949. 10.21037/apm-20-1863
    1. Yamamoto K., Takeshita H., Rakugi H. (2020). ACE2, Angiotensin 1-7 and Skeletal Muscle: Review in the Era of COVID-19. Clin. Sci. 134, 3047–3062. 10.1042/CS20200486
    1. Yelin D., Margalit I., Yahav D., Runold M., Bruchfeld J. (2021). Long COVID-19-It's Not over until? Clin. Microbiol. Infect. 27, 506–508. 10.1016/j.cmi.2020.12.001
    1. Zahan T., Nasir M., Perveen R. A., Akhtar A., Rahman A. F. M. M., Farha N., et al. (2021). Overview of 254 Mild Cases of COVID-19 in Bangladeshi Cohort: a Cross-Sectional Observation. Int. J. Adv. Med. 8, 735–741. 10.18203/2349-3933.ijam20211896
    1. Zaim S., Chong J. H., Sankaranarayanan V., Harky A. (2020). COVID-19 and Multiorgan Response. Curr. Probl. Cardiol. 45, 100618. 10.1016/j.cpcardiol.2020.100618
    1. Zaki N., Mohamed E. A. (2021). The Estimations of the COVID-19 Incubation Period: A Scoping Reviews of the Literature. J. Infect. Public Health 14, 638–646. 10.1016/j.jiph.2021.01.019
    1. Zhang H., Charmchi Z., Seidman R. J., Anziska Y., Velayudhan V., Perk J. (2020b). COVID ‐19-associated Myositis with Severe Proximal and Bulbar Weakness. Muscle & Nerve 62, E57–E60. 10.1002/mus.27003
    1. Zhang Q., Shan K. S., Minalyan A., O'Sullivan C., Nace T. (2020a). A Rare Presentation of Coronavirus Disease 2019 (COVID-19) Induced Viral Myositis with Subsequent Rhabdomyolysis. Cureus 12, e8074. 10.7759/cureus.8074

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する