Postdischarge rheumatic and musculoskeletal symptoms following hospitalization for COVID-19: prospective follow-up by phone interviews

Abstract

To describe the rheumatic and musculoskeletal symptoms at hospitalization as well as their persistence/severity after discharge with coronavirus disease 2019 (COVID-19) and to identify whether age, sex, body mass index (BMI), and length of hospital stay are associated with persistence of these symptoms. In this single-center cohort study, comprising 300 participants, two phone interviews were conducted (2-week and 1-month after hospitalization) and symptoms were queried with a standardized form. This form included musculoskeletal symptoms and other COVID-19 symptoms. Considering all symptoms (musculoskeletal and other), 100.0%, 86.7%, and 72.0% of patients reported one or more symptoms, at hospitalization, 2-week, and 1-month, respectively. Considering only musculoskeletal symptoms, 92.3%, 72.7%, and 56.3% of patients reported any musculoskeletal symptom at hospitalization, 2-week, and 1-month, respectively. The musculoskeletal symptoms were fatigue (44.3% of patients reported), back pain (22.7%), arthralgia (22.0%), myalgia (21.0%), low back pain (16.3%), and neck pain (10.3%); the other symptoms were shortness of breath (26.3%), loss of taste (15.0%), cough (14.0%), loss of smell (12.3%), loss of appetite (10.3%), headache (8.7%), sore throat (3.0%), diarrhea (1.3%), dizziness (1.3%), and fever (0.3%) at 1-month. Increasing BMI was associated with higher odds of persistence of fatigue (OR: 1.08, 1.03 to 1.13), myalgia (OR: 1.08, 1.01 to 1.14), and arthralgia (OR: 1.07, 1.02 to 1.14, p = 0.012) at 1-month. Nearly three-quarters reported one or more symptoms, with more than half of patients reported any musculoskeletal symptom at 1 month. The most common musculoskeletal symptom was fatigue, followed by back pain, arthralgia, myalgia, low back pain, and neck pain. The persistence of fatigue, myalgia, and arthralgia was related to BMI. The study results increase our understanding of the spectrum of COVID-19, which, in turn, may lead to more efficient and better care for COVID-19 survivors. Supplementary Information The online version contains supplementary material available at 10.1007/s00296-021-04882-8.

Musculoskeletal symptoms and related factors in postacute COVID‐19 patients

“…The frequencies recorded in the present study were, thus, higher than those in the other Turkish study. On the other hand, similar to our study, Karaarslan et al 4 also reported that back pain was the most common form of pain, the knee was the most common site of joint pain and that fatigue was the most common symptom.…”

“…Similar to our study, other studies have reported that dyspnoea was present in one‐quarters of postacute COVID‐19 patients. 4 , 7 …”

“…Consistent with the results of our study, many other studies have reported that fatigue is commonly seen after recovery from infection. 2 , 3 , 4 , 7 Perrin et al 16 reported that many acute COVID‐19 patients developed chronic fatigue as a part of “post‐COVID‐19 syndrome”. Hives et al 17 showed that pro‐inflammatory molecules (interferon gamma, interleukins, etc) are related to chronic fatigue syndrome.…”

“…These studies examined the most frequent symptoms. For example, Karaarslan et al 4 reported the most frequent musculoskeletal symptoms as “fatigue and back pain”, while Numan et al 5 reported the most common symptom to be “pain in the lower limb”. These results are conflicting, and the relationship between prognostic factors, such as laboratory and chest computed tomography (CT), and postacute COVID‐19 musculoskeletal symptoms has not yet been investigated to the best of our knowledge.…”

Case Report of a Saga of Post-COVID-19 Complications

“…However, MRI findings and histopathology helped rule it out. The musculoskeletal and rheumatic symptoms of COVID-19 (i.e., myalgia, fatigue, arthralgia) have been attributed to systemic immune response, pro-inflammatory cytokine release, and direct invasion/injury of musculoskeletal cells by SARS-CoV-2 through the ACE2 receptor [ 8 ].…”