A relationship between musculoskeletal pain and prognosis in hospitalized COVID-19 patients

Year 2021, Volume: 4 Issue: 3, 300 - 305, 21.05.2021

Esra Demirel Ali Şahin , Mustafa Utlu , Şahin Çepni , Enejd Veizi , Betül Gülsüm Yavuz Veizi

https://doi.org/10.32322/jhsm.899515

Cited By: 2

Abstract

Introduction: Musculoskeletal system complaints are often encountered in patients with Covid-19. The aim of this study was to evaluate the frequency of symptoms such as arthralgia, myalgia, and arthritis in hospitalized patients and their relationship with the final prognosis.

Methods: Complaints related to myalgia, arthralgia, arthritis-like symptoms, laboratory parameters, VAS scores and localized painful areas of 154 hospitalized patients who were treated with a COVID-19 diagnosis were recorded on admission and during their hospitalization period. The relationship between these clinical and laboratory data and the duration of hospital stays, need for intensive care and death-recovery states was evaluated.

Results: Of 154 cases, 45.5% (n=70) were female, 71.4% (n=110) had myalgia while 55.8% (n=86) had arthralgia. Mean VAS value was 6.39±2.04. The most commonly reported painful locations were dorsum in 68.2% (n=75) and chest in 63.6% (n=70) of the patients. The death rate was significantly higher in patients with dorsum pain. 25-0H-Vitamin D levels did not have a significant effect on the prognosis and in terms of needing intensive care.

Conclusion: Myalgia and arthralgia are present in a significant part of patients with a diagnosis of Covid-19. Pain localized in the chest and dorsum area is associated with bad prognosis.

Keywords

COVID-19, myalgia, arthralgia, pain areas, prognosis

References

• Fraser DD, Cepinskas G, Slessarev M, Martin C, Daley M, Miller MR, et al. Inflammation Profiling of Critically Ill Coronavirus Disease 2019 Patients. Crit Care Explor 2020; 2: e0144.
• Kotfis K, Skonieczna-Zydecka K. COVID-19: gastrointestinal symptoms and potential sources of SARS-CoV-2 transmission. Anaesthesiol Intensive Ther 2020; 52: 171-2.
• Gu J, Han B, Wang J. COVID-19: Gastrointestinal Manifestations and Potential Fecal-Oral Transmission. Gastroenterology 2020; 158: 1518-9.
• Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506.
• Park SE. Epidemiology, virology, and clinical features of severe acute respiratory syndrome -coronavirus-2 (SARS-CoV-2; Coronavirus Disease-19). Clin Exp Pediatr 2020; 63: 119-24.
• Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-62.
• Pung R, Chiew CJ, Young BE, Chin S, Chen MI, Clapham HE, et al. Investigation of three clusters of COVID-19 in Singapore: implications for surveillance and response measures. Lancet 2020; 395: 1039-46.
• Godaert L, Proye E, Demoustier-Tampere D, Coulibaly PS, Hequet F, Drame M. Clinical characteristics of older patients: The experience of a geriatric short-stay unit dedicated to patients with COVID-19 in France. J Infect 2020; 81: e93-e4.
• Drozdzal S, Rosik J, Lechowicz K, Machaj F, Szostak B, Majewski P, et al. COVID-19: Pain Management in Patients with SARS-CoV-2 Infection-Molecular Mechanisms, Challenges, and Perspectives. Brain Sci 2020; 10: 465.
• Kotfis K, Zegan-Barańska M, Szydłowski Ł, Żukowski M, Ely EW. Methods of pain assessment in adult intensive care unit patients—Polish version of the CPOT (Critical Care Pain Observation Tool) and BPS (Behavioral Pain Scale). Anaesthesiology intensive therapy 2017; 49: 66-72.
• Margolis RB, Tait RC, Krause SJ. A rating system for use with patient pain drawings. Pain 1986; 24: 57-65.
• Park M, Cook AR, Lim JT, Sun Y, Dickens BL. A Systematic Review of COVID-19 Epidemiology Based on Current Evidence. J Clin Med 2020; 9: 967.
• Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507-13.
• Cipollaro L, Giordano L, Padulo J, Oliva F, Maffulli N. Musculoskeletal symptoms in SARS-CoV-2 (COVID-19) patients. Springer; 2020.
• Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. European Archives of Oto-Rhino-Laryngology 2020; 277: 2251-61.
• Ebrahim SH, Memish ZA. COVID-19 - the role of mass gatherings. Travel Med Infect Dis 2020; 34: 101617.
• Hartman-Maeir A, Soroker N, Ring H, Avni N, Katz N. Activities, participation and satisfaction one-year post stroke. Disabil Rehabil 2007; 29: 559-66.
• Huang YH, Wu CY, Hsieh YW, Lin KC. Predictors of change in quality of life after distributed constraint-induced therapy in patients with chronic stroke. Neurorehabil Neural Repair 2010; 24: 559-66.
• He J, Song C, Liu E, Liu X, Wu H, Lin H, et al. Establishment of Routine Clinical Indicators-Based Nomograms for Predicting the Mortality in Patients with COVID-19. 2020.
• Shi Y, Yu X, Zhao H, Wang H, Zhao R, Sheng J. Host susceptibility to severe COVID-19 and establishment of a host risk score: findings of 487 cases outside Wuhan. Crit Care 2020; 24: 108.
• Jiang X, Coffee M, Bari A, Wang J, Jiang X, Huang J, et al. Towards an artificial intelligence framework for data-driven prediction of coronavirus clinical severity. Computers, Materials & Continua 2020; 63: 537-51.
• Lippi G, Wong J, Henry BM. Myalgia may not be associated with severity of coronavirus disease 2019 (COVID-19). World J Emerg Med 2020; 11: 193-4.
• Chen T, Wu D, Chen H, Yan W, Yang D, Chen G. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study [published online March 26, 2020]. BMJ 2020.
• Uz C, Umay E, Gundogdu I, Uz F. Back Pain and Related Factors in Patients with COVID-19. 2020.
• Lee RW, Hodgson LE, Jackson MB, Adams N. Problem based review: pleuritic chest pain. Acute Med 2012; 11: 172-82.
• Daneshkhah A, Agrawal V, Eshein A, Subramanian H, Roy HK, Backman V. The possible role of vitamin D in suppressing cytokine storm and associated mortality in COVID-19 patients. MedRxiv 2020.
• Dancer RC, Parekh D, Lax S, D'Souza V, Zheng S, Bassford CR, et al. Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS). Thorax 2015; 70: 617-24.
• Jones SE, Maddocks M, Kon SS, Canavan JL, Nolan CM, Clark AL, et al. Sarcopenia in COPD: prevalence, clinical correlates and response to pulmonary rehabilitation. Thorax 2015; 70: 213-8.
• Amrein K, Zajic P, Schnedl C, Waltensdorfer A, Fruhwald S, Holl A, et al. Vitamin D status and its association with season, hospital and sepsis mortality in critical illness. Crit Care 2014; 18: R47.
• Amrein K, Schnedl C, Holl A, Riedl R, Christopher KB, Pachler C, et al. Effect of high-dose vitamin D3 on hospital length of stay in critically ill patients with vitamin D deficiency: the VITdAL-ICU randomized clinical trial. JAMA 2014; 312: 1520-30.