Skeletal muscle injury in COVID infection: Frequency and patterns

Abstract

Introduction/AimsLittle is known about skeletal muscle injury with coronavirus disease 2019 (COVID‐19). We estimate the frequency and explore the patterns of skeletal muscle injury in acute COVID‐19.MethodsA cohort of COVID patients with mild to moderate symptoms were evaluatedin a COVID designated hospitalbetween May andDecember 2021 and followed for 2 weeks. Skeletal muscle injury was assessed with creatine kinase (CK) levels, manual muscletesting 8(MMT‐8) and the Health Assessment Questionnaire (HAQ); and was defined as CK >200 IU/L with MMT‐8 < 76. The association between such injury, and severity and outcomes wereevaluated using cross tabulations.ResultsTwo hundred and fifty participants with a mean age of 50.2 years (SD: 17.2) were included. One hundred and nine (43.6%) were women; 84 (34%) developedsevere disease. Median CK levels were 91 IU/L (IQR: 56,181). Weaknesson MMT‐8 (247, 98.8%) and disability on HAQ (107; 42.8%) were common. Neck flexor muscles wereprominently affected. Skeletal muscle injury was seen in 22.4% (95% CI: 17.4–28.1). There was nosignificant association between skeletal muscle injury and maximal severity of illness or short term outcomes. Disability increased over 14 days in most survivors (172; 72.3%) and this was not seen in those with mild disease (OR:0.4; 95% CI: 0.22–0.70).DiscussionSkeletal muscle injury appears to be common in people presenting with mild to moderate COVID infection.