Musculoskeletal Manifestations of COVID-19: Currently Described Clinical Symptoms and Multimodality Imaging Findings

Omar, Imran M.; Weaver, Jennifer S.; Samet, Jonathan D.; Serhal, Ali M.; Mar, Woongchon; Taljanovic, Mihra S.

doi:10.1148/rg.220036

Cited by 21 publications

(10 citation statements)

References 77 publications

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“…MR imaging was used to diagnose various COVID-19–related MSK findings, most commonly for patients with prolonged hospitalizations [ 54 , 55 ]. MSK manifestations of COVID-19 may persist or occur months after the initial infection, known as post-COVID syndrome [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Clinical Findings in Medical Imaging Exams in a Nationwide Israeli Health Organization: Observational Study

Ozery-Flato¹,

Ein-Dor²,

Pinchasov³

et al. 2023

JMIR Form Res

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Background The outbreak of the COVID-19 pandemic had a major effect on the consumption of health care services. Changes in the use of routine diagnostic exams, increased incidences of postacute COVID-19 syndrome (PCS), and other pandemic-related factors may have influenced detected clinical conditions. Objective This study aimed to analyze the impact of COVID-19 on the use of outpatient medical imaging services and clinical findings therein, specifically focusing on the time period after the launch of the Israeli COVID-19 vaccination campaign. In addition, the study tested whether the observed gains in abnormal findings may be linked to PCS or COVID-19 vaccination. Methods Our data set included 572,480 ambulatory medical imaging patients in a national health organization from January 1, 2019, to August 31, 2021. We compared different measures of medical imaging utilization and clinical findings therein before and after the surge of the pandemic to identify significant changes. We also inspected the changes in the rate of abnormal findings during the pandemic after adjusting for changes in medical imaging utilization. Finally, for imaging classes that showed increased rates of abnormal findings, we measured the causal associations between SARS-CoV-2 infection, COVID-19–related hospitalization (indicative of COVID-19 complications), and COVID-19 vaccination and future risk for abnormal findings. To adjust for a multitude of confounding factors, we used causal inference methodologies. Results After the initial drop in the utilization of routine medical imaging due to the first COVID-19 wave, the number of these exams has increased but with lower proportions of older patients, patients with comorbidities, women, and vaccine-hesitant patients. Furthermore, we observed significant gains in the rate of abnormal findings, specifically in musculoskeletal magnetic resonance (MR-MSK) and brain computed tomography (CT-brain) exams. These results also persisted after adjusting for the changes in medical imaging utilization. Demonstrated causal associations included the following: SARS-CoV-2 infection increasing the risk for an abnormal finding in a CT-brain exam (odds ratio [OR] 1.4, 95% CI 1.1-1.7) and COVID-19–related hospitalization increasing the risk for abnormal findings in an MR-MSK exam (OR 3.1, 95% CI 1.9-5.3). Conclusions COVID-19 impacted the use of ambulatory imaging exams, with greater avoidance among patients at higher risk for COVID-19 complications: older patients, patients with comorbidities, and nonvaccinated patients. Causal analysis results imply that PCS may have contributed to the observed gains in abnormal findings in MR-MSK and CT-brain exams.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Clinical Findings in Medical Imaging Exams in a Nationwide Israeli Health Organization: Observational Study

Ozery-Flato¹,

Ein-Dor²,

Pinchasov³

et al. 2023

JMIR Form Res

View full text Add to dashboard Cite

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“…A previous study reported that during the pandemic, the number of radiologists in the office decreased dramatically as more people chose to work from home [ 31 ]. Possibly because of the greater severity of other organ system manifestations of COVID-19, the musculoskeletal (MSK) manifestations of this virus have not been completely reported [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Work-related musculoskeletal symptoms among Saudi radiologists: a cross-sectional multi-centre study

Alelyani

Gameraddin

Khushayl

et al. 2023

BMC Musculoskelet Disord

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Background Musculoskeletal disorders are common health problems worldwide. Several factors cause these symptoms, including ergonomics and other individual considerations. Computer users are prone to repetitive strain injuries that increase the risk of developing musculoskeletal symptoms (MSS). Radiologists are susceptible to developing MSS because they work long hours analysing medical images on computers in an increasingly digitalised field. This study aimed to identify the prevalence of MSS among Saudi radiologists and the associated risk factors. Methods This study was a cross-sectional, non-interventional, self-administered online survey. The study was conducted on 814 Saudi radiologists from various regions in Saudi Arabia. The study's outcome was the presence of MSS in any body region that limited participation in routine activities over the previous 12 months. The results were descriptively examined using binary logistic regression analysis to estimate the odds ratio (OR) of participants who had disabling MSS in the previous 12 months. All university, public, and private radiologists received an online survey containing questions about work surroundings, workload (e.g., spent at a computer workstation), and demographic characteristics. Results The prevalence of MSS among the radiologists was 87.7%. Most of the participants (82%) were younger than 40 years of age. Radiography and computed tomography were the most common imaging modalities that caused MSS (53.4% and 26.8%, respectively). The most common symptoms were neck pain (59.3%) and lower back pain (57.1%). After adjustment, age, years of experience, and part-time employment were significantly associated with increased MSS (OR = .219, 95% CI = .057–.836; OR = .235, 95% CI = 087–.634; and OR = 2.673, 95% CI = 1.434–4.981, respectively). Women were more likely to report MSS than males (OR = 2.12, 95% CI = 1.327–3.377). Conclusions MSS are common among Saudi radiologists, with neck pain and lower back pain being the most frequently reported symptoms. Gender, age, years of experience, type of imaging modality, and employment status were the most common associated risk factors for developing MSS. These findings are vital for the development of interventional plans to reduce the prevalence of musculoskeletal complaints in clinical radiologists.

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“…However, the incidence of thrombotic events possibly associated with the clinical profile of COVID-19 patients may also contribute with poor vascularization of peripheral vessels in the muscles ( 4 ) and might generate biochemical repercussions in the musculoskeletal system. The pathogenetic mechanisms can also involve increased production of proinflammatory cytokines, immune cell hyperactivation, direct viral entry of neurological and musculoskeletal system cells, and psychological stress ( 18 – 25 ). The cognitive and behavioral aspects may be also associated with the occurrence of musculoskeletal pain in these patients ( 18 – 22 ).…”

Section: Introductionmentioning

confidence: 99%

“…The cognitive and behavioral aspects may be also associated with the occurrence of musculoskeletal pain in these patients ( 18 – 22 ). Considering specifically joint pain, some findings show a prevalence that may vary between 2.5% and 23% of patients ( 21 – 25 ). Myalgias and generalized weakness have also been reported in studies with a prevalence between 25% and 50% of symptomatic COVID-19 patients ( 23 ).…”

Section: Introductionmentioning

confidence: 99%

Hospital admission is associated with disability and late musculoskeletal pain in individuals with long COVID

Neto,

Reis,

Ferreira

et al. 2023

Front. Rehabil. Sci.

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BackgroundThe acute clinical repercussions of SARS-CoV-2 infection have been widely studied. However, the possible late repercussions of long COVID have not yet been well defined in the literature.ObjectivesTo identify the presence of pain and musculoskeletal disability in patients with Long COVID and also to identify predictive factors for pain intensity in this population.MethodsIn this cross-sectional and retrospective observational study individuals with Long COVID symptoms were included. It was collected musculoskeletal disability measures, data from patient-related outcome measures and variables from a COVID-19 outpatient service database. Associations and sub-group analyses were performed considering the variables pain, disability and hospitalization. Linear regression was performed to identify predictive factors for pain intensity in Long COVID patients.ResultsWe evaluated 195 patients and most of them (57%) presented musculoskeletal pain in one area of the body. Pain sub-group presented worse disability indices and worse clinical course during hospitalization. Hospitalized patients presented worse disability indices comparing to non-hospitalized. Significant correlations were found between pain and days of non-invasive oxygen support (r = 0.21; p = 0.003); days in intensive care unit (r = 0.22; p = 0.002) and days in invasive mechanical ventilation (r = 0.35; p = 0.001). Hospitalized individuals showed a higher chance of presenting late musculoskeletal pain (OR = 1.42: 95%CI 1.09–2.04). Days in intensive care unit (β = 0,234: P = 0,001) and days in invasive mechanical ventilation (β = 0.764: P = 0.001) were predictors of pain intensity [F(2,192) = 18.559; R2 = 0.231; p = 0.001].ConclusionIndividuals with Long COVID presented musculoskeletal pain and disability. Hospitalized patients showed a greater chance of having musculoskeletal pain. Days in intensive care unit and days in invasive mechanical ventilation were predictors of late musculoskeletal pain intensity.

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Musculoskeletal Manifestations of COVID-19: Currently Described Clinical Symptoms and Multimodality Imaging Findings

Cited by 21 publications

References 77 publications

Impact of the COVID-19 Pandemic on Clinical Findings in Medical Imaging Exams in a Nationwide Israeli Health Organization: Observational Study

Impact of the COVID-19 Pandemic on Clinical Findings in Medical Imaging Exams in a Nationwide Israeli Health Organization: Observational Study

Work-related musculoskeletal symptoms among Saudi radiologists: a cross-sectional multi-centre study

Hospital admission is associated with disability and late musculoskeletal pain in individuals with long COVID

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