Jeyaraman Madhan, Selvaraj Preethi, Jeyaraman Naveen, Gollahalli Shivashankar Prajwal, Muthu Sathish
Department of Orthopaedics, Faculty of Medicine, Sri Lalithambigai Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu, India.
Orthopaedic Research Group, Coimbatore, Tamil Nadu, India.
J Orthop. 2022 Sep-Oct;33:131-136. doi: 10.1016/j.jor.2022.07.011. Epub 2022 Jul 21.
Musculoskeletal manifestations of COVID-19, post COVID-19, and post COVID-19 vaccination include arthralgia, myalgia, new-onset backache, fatigue, inflammatory arthritis either symmetrical or polyarticular, reactive arthritis, osteoporosis, osteonecrosis of the femoral head, neuropathies, myositis, and myopathies. Almost 15% and 44% of post-COVID-19 patients reported arthralgia and myalgia. We aim to analyze the musculoskeletal manifestations of COVID-19 infection and the factors determining their severity.
This is a retrospective multicentric cross-sectional study conducted from all the four regions (northern, southern, eastern, and western regions) in India. The recruitment period was from June 1st, 2021, to September 30th, 2021. All patients with COVID-19 positivity in the past were classified into three groups (mild, moderate, and severe). The primary outcome is to find the correlation of musculoskeletal symptoms with disease positivity, severity, and demographic variables. We focused at clinical characteristics and symptoms at the time of admission, as well as comorbidities, laboratory findings, immunological findings, treatments, and outcomes.
The study was conducted among 2334 subjects across all the regions of India. Out of which 719 were COVID-19 positive individuals. Non-vaccinated were about 62.6% compared to 37.4% vaccinated among COVID-19 positive individuals. The total average musculoskeletal scores calculated were about 15.94 ± 54.86. MSK scores were significantly higher (p < 0.001) among males, uneducated, those with co-morbidities, and non-vaccinated individuals. Multivariate regression analysis showed a 1.63 times higher risk of having COVID-19 infection among smokers, those who don't exercise regularly are 1.25 times at risk of having COVID-19 infection. Similarly, those who have comorbidities are 1.93 times at risk of having COVID-19 infection. Non-vaccinated individuals were 2.33 times at risk of having COVID-19 infection.
Factors such as male sex, non-vaccination, and associated co-morbidities increased the risk of developing severe MSK manifestations upon infection with COVID-19 and needs extended monitoring to control the morbidity due to the same.
新型冠状病毒肺炎（COVID-19）感染期、感染后及感染后接种疫苗后的肌肉骨骼表现包括关节痛、肌痛、新发背痛、疲劳、对称性或多关节性炎症性关节炎、反应性关节炎、骨质疏松症、股骨头坏死、神经病变、肌炎和肌病。近15%和44%的COVID-19感染后患者报告有关节痛和肌痛。我们旨在分析COVID-19感染的肌肉骨骼表现及其严重程度的决定因素。
这是一项在印度所有四个地区（北部、南部、东部和西部地区）进行的回顾性多中心横断面研究。招募期为2021年6月1日至2021年9月30日。所有过去COVID-19检测呈阳性的患者被分为三组（轻度、中度和重度）。主要结果是找出肌肉骨骼症状与疾病阳性、严重程度和人口统计学变量之间的相关性。我们关注入院时的临床特征和症状，以及合并症、实验室检查结果、免疫学检查结果、治疗方法和预后。
该研究在印度所有地区的2334名受试者中进行。其中719人为COVID-19阳性个体。在COVID-19阳性个体中，未接种疫苗的约占62.6%，接种疫苗的占37.4%。计算出的肌肉骨骼总平均得分约为15.94±54.86。男性、未受过教育者、有合并症者和未接种疫苗者的肌肉骨骼得分显著更高（p<0.001）。多变量回归分析显示，吸烟者感染COVID-19的风险高1.63倍，不经常锻炼者感染COVID-19的风险高1.25倍。同样，有合并症者感染COVID-19的风险高1.93倍。未接种疫苗者感染COVID-19的风险高2.33倍。
男性、未接种疫苗以及合并相关疾病等因素增加了感染COVID-19后出现严重肌肉骨骼表现的风险，需要进行长期监测以控制由此导致的发病率。
