Wang Lijuan, Yang Na, Yang Jinfeng, Zhao Shuwu, Su Chen
Department of Anesthesiology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
Department of Medicine, University of South China, Hengyang, China.
Front Pain Res (Lausanne). 2022 Mar 10;3:826160. doi: 10.3389/fpain.2022.826160. eCollection 2022.
The outbreak of COVID-19 poses a serious threat to global health. Musculoskeletal (MSK) pain is the most frequent symptom in patients with COVID-19 besides fever and cough. There are limited studies addressing MSK symptoms in patients with COVID-19. This review aims to provide an overview of current studies related to MSK pain in patients with COVID-19, summarize the possible mechanisms of myalgia, and describe the current management options. In addition to acute respiratory manifestations, COVID-19 might also affect neurological systems which include skeletal manifestations and muscular injury. A possible mechanism of MSK pain and myalgia in COVID-19 may be related to the distribution of angiotensin-converting enzyme 2 (ACE-2) and the occurrence of cytokine storms. ACE-2 has been shown to be the receptor of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV2). Moreover, studies have shown that inflammatory cytokines could cause myalgia by inducing prostaglandin E2 (PGE2) production. In addition, it was also found that the plasma levels of IL2, IL7, IL10, IL-6, TNFα, and e lymphopenia were higher in patients with COVID-19. In general, the treatment of MSK pain in patients with COVID-19 falls into pharmacological and non-pharmacological interventions. Various treatments of each have its own merits. The role of vaccination is irreplaceable in the efforts to prevent COVID-19 and mitigates its subsequent symptoms.
新型冠状病毒肺炎（COVID-19）疫情对全球健康构成严重威胁。肌肉骨骼（MSK）疼痛是COVID-19患者除发热和咳嗽外最常见的症状。针对COVID-19患者MSK症状的研究有限。本综述旨在概述当前与COVID-19患者MSK疼痛相关的研究，总结肌痛的可能机制，并描述当前的管理方案。除急性呼吸道表现外，COVID-19还可能影响神经系统，包括骨骼表现和肌肉损伤。COVID-19中MSK疼痛和肌痛的一种可能机制可能与血管紧张素转换酶2（ACE-2）的分布和细胞因子风暴的发生有关。ACE-2已被证明是严重急性呼吸综合征冠状病毒2（SARS-COV2）的受体。此外，研究表明炎症细胞因子可通过诱导前列腺素E2（PGE2）生成引起肌痛。另外，还发现COVID-19患者的白细胞介素2（IL2）、白细胞介素7（IL7）、白细胞介素10（IL10）、白细胞介素-6（IL-6）、肿瘤坏死因子α（TNFα）血浆水平及淋巴细胞减少情况较高。总体而言，COVID-19患者MSK疼痛的治疗分为药物和非药物干预。每种干预的各种治疗方法都有其优点。疫苗接种在预防COVID-19及其后续症状的努力中作用不可替代。
