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新冠后综合征中肌肉骨骼系统损伤的临床体征、病程及治疗特点

Peculiarities of clinical signs, course and treatment of musculoskeletal system lesions in post-COVID syndrome.

作者信息

Voloshyna Larysa, Smiyan Svitlana, Voloshyn Oleksandr, Buzdugan Inna, Bukach Olga, Voloshynovych Natalia, Doholich Oleksandra

机构信息

Bucovinian State Medical University, State Medical Institute, Chernivtsi, Ukraine.

Danylo Halytsky Lviv National Medical University, I. Horbachevsky Ternopil National Medical University, National Scientific Center "MD Strazhesko Institute of Cardiology", Ukraine.

出版信息

Reumatologia. 2023;61(5):339-344. doi: 10.5114/reum/172575. Epub 2023 Oct 31.

Abstract

INTRODUCTION

Post-COVID syndrome (PCS) is a frequent phenomenon of patients who have suffered from an acute attack of COVID-19 infection, and it is characterized by a wide range of symptoms from different organs and systems including the musculoskeletal system (MSS). However, peculiarities of MSS lesions have not been sufficiently studied to date, in particular, in the aspect of the therapeutic process. We aimed to investigate peculiarities of MSS lesions in patients with PCS.

MATERIAL AND METHODS

Observations were carried out in 142 patients with PCS and MSS lesions. The age of patients was 36-67 years. Up-to-date methods of disease verification were used. An acute period of COVID-19 in all the patients was of moderate severity without oxygen support.

RESULTS

Musculoskeletal system lesions in patients with PCS were found to appear 1-4 weeks after the experienced acute period of COVID-19 infection. Against the background of significant arthralgia (100%) in 93 (65.5%) patients manifestations of acute arthritis were detected, the frequency of which increased with age. Musculoskeletal system lesions were found against the background of dominating PCS manifestations from the cardiovascular and digestive systems. Deterioration of the course and results of treatment of diseases caused by an age-related polymorbid background was determined. Certain difficulties in the treatment of MSS lesions by means of non-steroidal anti-inflammatory drugs and limitation in the use of glucocorticosteroids are caused by severe gastroduodenopathy and arterial hypertension. Long-term, up to 6 months, administration of L-arginine, L-carnitine and quercetin in the rehabilitation complex improved the overall results of treatment of PCS manifestations including arthropathy.

CONCLUSIONS

Musculoskeletal system lesions in patients with PCS are not the main constituent of this syndrome. Difficulties in the treatment of arthropathy are due to the signs of gastroduodenopathy and arterial hypertension. Additional administration of L-arginine, L-carnitine and quercetin is reasonable.

摘要

引言

新冠后综合征(PCS)是感染新冠病毒急性发作患者中常见的现象,其特征是来自不同器官和系统(包括肌肉骨骼系统,MSS)的一系列症状。然而,迄今为止,MSS病变的特点尚未得到充分研究,尤其是在治疗过程方面。我们旨在研究PCS患者MSS病变的特点。

材料与方法

对142例患有PCS且有MSS病变的患者进行了观察。患者年龄为36至67岁。采用了最新的疾病核查方法。所有患者新冠病毒感染的急性期病情为中度,无需氧疗支持。

结果

发现PCS患者的肌肉骨骼系统病变在经历新冠病毒感染急性期后的1至4周出现。在93例(65.5%)有明显关节痛(100%)的患者中检测到急性关节炎表现,其发生率随年龄增加。肌肉骨骼系统病变是在心血管和消化系统为主的PCS表现背景下发现的。确定了由年龄相关的多病症背景导致的疾病治疗过程和结果的恶化。严重的胃十二指肠疾病和动脉高血压导致使用非甾体抗炎药治疗MSS病变存在一定困难以及糖皮质激素使用受限。在康复综合治疗中,长期(长达6个月)给予L-精氨酸、L-肉碱和槲皮素改善了包括关节病在内的PCS表现的总体治疗效果。

结论

PCS患者的肌肉骨骼系统病变不是该综合征的主要组成部分。关节病治疗困难是由于胃十二指肠疾病和动脉高血压的体征。额外给予L-精氨酸、L-肉碱和槲皮素是合理的。

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