Evaluation of musculoskeletal system symptoms and hematological parameters in COVID-19 patients

Musculoskeletal system symptoms in COVID-19 patients

Authors

DOI:

https://doi.org/10.5281/zenodo.7363728

Keywords:

COVID-19, hematological parameters, inflammation, musculoskeletal pain

Abstract

Objective: Musculoskeletal pain can be seen in COVID-19; however, the data obtained about pain intensity and its relationship with inflammation are not of sufficient. The aim of this study is to investigate the frequency of musculoskeletal pains in patients diagnosed as having COVID-19, and to determine the relationship between these symptoms and inflammatory parameters.

Methods: One hundred twenty-one patients who were diagnosed as having COVID-19 were included. All patients’ demographic data, complete blood count parameters, neutrophil/lymphocyte ratios (NLR), platelet/lymphocyte ratios (PLR), lymphocyte-monocyte ratios (LMR), and neutrophil/monocyte ratios (NMR) were recorded. All patients’ musculoskeletal pains and fatigue symptoms were investigated, and the severity of pain and fatigue was determined using a visual analog scale (VAS).

Results: The frequencies of myalgia, fatigue, back pain, and low back pain were 43%, 92%, 68%, and 56%, respectively. A positive correlation was determined between the severity of fatigue and platelet levels (p:0.013, r:0.249). A negative correlation was observed between hemoglobin levels and fatigue severity (p:0.014, r:-0.246). A negative clinical correlation was observed between hemoglobin levels and myalgia severities (p:0.013, r:-0.384). There was no significant clinical correlation between myalgia, low back pain, back pain, fatigue severity, and hematologic indices (NLR, NMR, PLR, and LMR) (p>0.05).

Conclusion: No correlation was found between the presence or severity of musculoskeletal symptoms, fatigue, and hematological indices in COVID-19. Further large-series studies are now needed to prove an association between inflammation and symptom severity in COVID-19. 

References

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.

Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433.

Lian J, Jin X, Hao S, Cai H, Zhang S, Zheng L, et al. Analysis of Epidemiological and Clinical Features in Older Patients With Coronavirus Disease 2019 (COVID-19) Outside Wuhan. Clin Infect Dis. 2020;71(15):740-47.

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(10223):497-506.

Cipollaro L, Giordano L, Padulo J, Oliva F, Maffulli N. Musculoskeletal symptoms in SARS-CoV-2 (COVID-19) patients. J Orthop Surg Res. 2020;15(1):178.

Paliwal VK, Garg RK, Gupta A, Tejan N. Neuromuscular presentations in patients with COVID-19. Neurol Sci. 2020;41(11):3039-56.

Hasan LK, Deadwiler B, Haratian A, Bolia IK, Weber AE, Petrigliano FA. Effects of COVID-19 on the Musculoskeletal System: Clinician's Guide. Orthop Res Rev. 2021;13:141-50.

Kucuk A, Cumhur Cure M, Cure E. Can COVID-19 cause myalgia with a completely different mechanism? A hypothesis. Clin Rheumatol. 2020;39(7):2103-04.

Ali S, Singh A, Sharief N, Yadav M, Siddiqui S, Pandey V, et al. Coronaviruses: An overview with special emphasis on COVID-19 outbreak with musculoskeletal manifestations. World J Orthop. 2021;12(9):620-28.

Waris A, Din M, Khalid A, Abbas Lail R, Shaheen A, Khan N, et al. Evaluation of hematological parameters as an indicator of disease severity in Covid-19 patients: Pakistan's experience. J Clin Lab Anal. 2021;35(6):e23809.

Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-68.

Liu Y, Du X, Chen J, Jin Y, Peng L, Wang HHX, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020;81(1):e6-e12.

COVID TSB Tedavi Rehberi [erisim 05 Nisan 2020] https://covid19bilgi. saglik. gov. tr/depo/rehberler. COVID-19_Rehberi pdf

Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17(1):45-56.

Wolfe F. Fatigue assessments in rheumatoid arthritis: comparative performance of visual analog scales and longer fatigue questionnaires in 7760 patients. J Rheumatol. 2004;31(10):1896-902.

Lai X, Wang M, Qin C, Tan L, Ran L, Chen D, et al. Coronavirus Disease 2019 (COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China. JAMA Netw Open. 2020;3(5):e209666.

Aggarwal A, Shrivastava A, Kumar A, Ali A. Clinical and Epidemiological Features of SARS-CoV-2 Patients in SARI Ward of a Tertiary Care Centre in New Delhi. J Assoc Physicians India. 2020;68(7):19-26.

Tuzun S, Keles A, Okutan D, Yildiran T, Palamar D. Assessment of musculoskeletal pain, fatigue and grip strength in hospitalized patients with COVID-19. Eur J Phys Rehabil Med. 2021;57(4):653-62.

Murat S, Dogruoz Karatekin B, Icagasioglu A, Ulasoglu C, İçten S, Incealtin O. Clinical presentations of pain in patients with COVID-19 infection. Ir J Med Sci. 2021;190(3):913-17.

Martin CA, Jenkins DR, Minhas JS, Gray LJ, Tang J, Williams C, et al. Leicester COVID-19 consortium. Socio-demographic heterogeneity in the prevalence of COVID-19 during lockdown is associated with ethnicity and household size: Results from an observational cohort study. EClinicalMedicine. 2020;25:100466.

Salaffi F, Giorgi V, Sirotti S, Bongiovanni S, Farah S, Bazzichi L, et al. The effect of novel coronavirus disease-2019 (COVID-19) on fibromyalgia syndrome. Clin Exp Rheumatol. 2021;39 Suppl 130(3):72-7.

Diatchenko L, Slade GD, Nackley AG, Bhalang K, Sigurdsson A, Belfer I, et al. Genetic basis for individual variations in pain perception and the development of a chronic pain condition. Hum Mol Genet. 2005;14(1):135-43.

Benetti E, Tita R, Spiga O, Ciolfi A, Birolo G, Bruselles A, et al. GEN-COVID Multicenter Study, Renieri A, Pinto AM. ACE2 gene variants may underlie interindividual variability and susceptibility to COVID-19 in the Italian population. Eur J Hum Genet. 2020;28(11):1602-14.

Islam MR, Hoque MN, Rahman MS, Alam ASMRU, Akther M, Puspo JA, et al. Genome-wide analysis of SARS-CoV-2 virus strains circulating worldwide implicates heterogeneity. Sci Rep. 2020;10(1):14004.

Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95(7):834-47.

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. Comput Mater Contin. 2020; 63:537-51

Batur EB, Korez MK, Gezer IA, Levendoglu F, Ural O. Musculoskeletal symptoms and relationship with laboratory findings in patients with COVID-19. Int J Clin Pract. 2021;75(6):e14135.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-69.

Prochaska MT, Newcomb R, Block G, Park B, Meltzer DO. Association Between Anemia and Fatigue in Hospitalized Patients: Does the Measure of Anemia Matter? J Hosp Med. 2017;12(11):898-904.

Rose SR, Petersen NJ, Gardner TJ, Hamill RJ, Trautner BW. Etiology of thrombocytosis in a general medicine population: analysis of 801 cases with emphasis on infectious causes. J Clin Med Res. 2012;4(6):415-23.

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Published

2022-11-26

How to Cite

Yakşi, E., Ademi, N., Karakaş, D., & Yakşi, O. (2022). Evaluation of musculoskeletal system symptoms and hematological parameters in COVID-19 patients: Musculoskeletal system symptoms in COVID-19 patients. The Injector, 1(3), 115–123. https://doi.org/10.5281/zenodo.7363728

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Original Article