Musculoskeletal Manifestations of COVID-19: A Systematic Search and Review

Coronavirus disease (COVID-19) started its journey around the world from Wuhan, China and gradually became a pandemic. COVID-19 often affects the respiratory system, but symptoms may include fatigue, myalgia, arthralgia, arthritis, and spine and bone pain as presenting complaints. In the present systematic search and review, we aim to highlight the musculoskeletal manifestations during COVID-19. PubMed Central and Google Scholar search engines were searched for the key words “muscle pain”, “joint pain”, “body ache”, and “fatigue”, in Covid-19 patients. After screening, a total of 76 articles dated between January 1 and July 1, 2020 met the inclusion criteria and were included in the study. All articles were published in English comprising 36,558 COVID-19 cases. In cross-sectional studies, fatigue was found in 55%, myalgia in 26%, and arthralgia in 20% of cases, respectively. In cohort studies, fatigue was found in 35%, myalgia in 15%, and arthralgia in 5%, respectively. Sporadic case reports also mention back pain, bone pain, myositis, and arthritis as presenting symptoms of COVID-19. Fatigue was the most frequent musculoskeletal (MSK) manifestation of COVID-19 followed by myalgia and joint pain. The frequency of the different MSK manifestations in COVID-19 may vary widely among different geographic regions. MSK like fatigue, myalgia and arthralgia are frequent symptoms in COVID-19 patients and may vary in different countries.