Clinical case of musculoskeletal system disorder in patients with COVID-19

Abstract

The pandemic of coronavirus 2 (severe acute respiratory syndrome (SARSCoV-2) has significantly changed lives around the world. Musculoskeletal symptoms can develop with SARS-CoV-2 as with other respiratory infections. Viral infections can be cause of arthritis, but the spectrum of symptoms can be quite wide, from arthralgia to chronic arthritis. Coronaviruses can be usually cause of arthralgia and myalgia rather than clinical arthritis. However, a syndrome of dysregulation and systemic overactivation of the immune system, described as a cytokine storm or hyperinflammatory syndrome, can developduring the course of COVID-19. As a result, coagulation and inflammation can significantly affect the progression of the disease and possibly lead to damageof the musculoskeletal system.The aim of the publication is to raise the awareness of rheumatologists and general practitioners, we offer a clinical case of the development of a musculoskeletal system lesion in a patient with COVID-19 and the successful treatment of this condition in this patient.Patients and methods. The article presents a clinical case of patient Z., who was diagnosed with joint lesions on the background of coronavirus infection.The patient was hospitalized in the rheumatology department of the Communal Non-profit Enterprise of the Kharkov Regional Council «Kharkiv RegionalHospital».Results and discussion. The patient underwent a full range of clinical and diagnostic studies and was prescribed systemic therapy with corticosteroids,supportive, as well as antibiotic therapy. The decrease of joint damage symptoms was noted during therapy. Subsequent observation was indicatedan improvement in the patient’s condition after the end of treatment in hospital.Conclusions. Our own experience in the treatment and management of the patient with a lesion of the musculoskeletal system against the background of coronavirus infection presens in the article. The data on clinical cases that were accompanied by joint damage against the background of COVID-19 or occurred some time after a viral infection were presented. Important practical clinical issues related to the diagnosis and management of patients withatypical manifestations of the disease are considered.

The effect of a physical therapy programme on the condition of upper limb muscles in patients with rheumatoid arthritis

“…Rheumatoid arthritis is a chronic progressive systemic disease of the connective tissue with damage to the joints, mainly small ones, a type of erosive-destructive polyarthritis and frequent systemic inflammatory lesions of the internal organs, registered in all countries of the world with a frequency of 0.4 to 1.5%. 1,2 This disease is one of the four large-scale medical problems of humanity, and more than 14 million people around the world suffer from it. 3 In Ukraine, the prevalence of rheumatoid arthritis is 340 cases per 100,000 of adult population, and the dis-ease mainly affects people of working age (20-50 years), which leads to frequent and long-term hospitalization, and often to disability.…”

“…14,15 Numerous clinical data indicate a high degree of reduction in physical activity of patients with rheumatoid arthritis due to impaired mobility and functional insufficiency of joints. 1,10,11,16,17 According to most authors, in order to increase the effectiveness of drug treatment, a special role is given to physical therapy, which should be an integral part of the comprehensive restorative treatment of patients with rheumatoid arthritis. 6,9,13,14,18,19 As of today, there is a need for the development and implementation of effective physical therapy technology, which would include an individual approach to the use of innovative restorative physical therapy measures, objective methods of evaluating the effectiveness of the measures and predicting the results.…”

Assessment of Hand Function in Patients With Rheumatoid Arthritis as a Result of Physical Therapy

“…Першими починають страждати дрібні суглоби пальців рук та ніг, зап'ястків, частіше ураження проявляється симетрично -якщо починають боліти суглоби на правій руці, трохи пізніше болі з'являються і на лівій [8]. Уражений суглоб втрачає здатність виконувати повний спектр рухів і внаслідок розвитку подальшого пошкодження структури суглоба, запалення та вторинних дегенеративних змін, порушення функції суглобів стає незворотнім [10,11].…”