Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. Nov 25, 2022; 11(6): 485-495
Published online Nov 25, 2022. doi: 10.5501/wjv.v11.i6.485
Musculoskeletal complications in long COVID-19: A systematic review
Raktim Swarnakar, Shoibam Jenifa, Sanjay Wadhwa
Raktim Swarnakar, Shoibam Jenifa, Sanjay Wadhwa, Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India
Author contributions: Swarnakar R and Wadhwa S contributed to conception and design of this study; Swarnakar R, Jenifa S and Wadhwa S contributed to literature search and writing.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sanjay Wadhwa, DNB, Professor & Head, Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Delhi, India. wadhwadr@gmail.com
Received: July 28, 2022
Peer-review started: July 28, 2022
First decision: August 22, 2022
Revised: September 1, 2022
Accepted: October 14, 2022
Article in press: October 14, 2022
Published online: November 25, 2022
Processing time: 118 Days and 2.6 Hours
Abstract
BACKGROUND

Coronavirus disease 2019 (COVID-19) has crippled humanity since early 2020. Various sequelae of COVID-19 have been reported in different body systems. Musculoskeletal symptoms are widely reported during COVID-19 infection, but musculoskeletal complications in long COVID-19 are underreported. However, post-COVID-19 survivors have reported complaints of persisting or new-onset fatigue, myalgia, arthralgia, arthritis, muscle weakness, etc in clinical practice. The well-known detrimental effects of steroids on the musculoskeletal system coupled with their over-the-counter availability can also be anticipated since they were the cornerstone of life-saving management in this pandemic.

AIM

To determine the musculoskeletal complications in long COVID.

METHODS

We performed a systematic review of ‘systematic reviews and meta-analyses’.

RESULTS

Of the 63 articles screened, 24 articles were included. Two articles specifically discussed children and adolescents. One article discussed rehabilitation intervention. No article addressed rehabilitation of musculoskeletal issues in long COVID-19 in particular. Fatigue was the most common musculoskeletal complication.

CONCLUSION

Fatigue is found to be very common along with myalgia and arthralgia. There were no studies on rehabilitation intervention in musculoskeletal complications specifically. Considering the lacuna in literature and the needs of the current situation, further studies are warranted to standardize effective rehabilitation interventions in musculoskeletal complications. More homogenous studies are needed. Studies on functional impairment due to musculoskeletal involvement are essential.

Keywords: Musculoskeletal complications; COVID-19; Long COVID-19; Post-COVID-19 syndrome; Rehabilitation; SARS-CoV-2

Core Tip: Though musculoskeletal involvement is reported in severe acute respiratory syndrome coronavirus 2 infection, the literature is limited for musculoskeletal symptoms in long coronavirus disease 2019 (COVID-19). Moreover, rehabilitation of each musculoskeletal complaint is not addressed in most reviews. We highlighted those keys areas through our review article. Fatigue is the most common musculoskeletal issue in long COVID-19. Considering the gaps in literature and current needs, future studies are warranted to standardize effective rehabilitation interventions in musculoskeletal complications.