What awaits us after covid-19? Musculoskeletal system involvement in the elderly population in Turkiye and its aftermath

Abstract

Introduction: Although COVID-19 primarily affects the respiratory system, one of the most frequently effected areas is the musculoskeletal system. COVID-19 associated musculoskeletal problems can cause disability in patients >= 65 years. The aim of the study was to define the musculoskeletal problems after the COVID-19 infection and to examine the relationship with the accompanying comorbidities in geriatric population.Materials and Method: The study was conducted by the members of Geriatric Rehabilitation Study Group of Turkish Physical Medicine and Rehabilitation Society at 11 different hospitals from 7 provinces (Ankara, stanbul, zmir, Gaziantep, Adana, Bursa, and Kirikkale) of Turkiye. Individuals aged 65 years and over who had a history of COVID-19 within the last 12 months and experienced persistent/continuous musculoskeletal complaints were included into the study. COVID-19 diagnoses were confirmed from electronic hospital records and the e-Nabiz system. Data were collected by face-to-face interviews and after recruiting the first 50 patients from each center, patient recruitment was terminated.Results: A total of 457 cases in which all questions were answered completely (without any missing data) were included in this observational study. The cases were mainly 65-75 years old, married, and non-smoking women. The most common musculoskeletal involvement was widespread pain (81%), followed by myalgia (63.7%) and arthralgia (44.4%). Other rare involvements (osteonecrosis, myositis, steroid myopathy, arthritis) were significantly more frequent in patients older than 75 years, regardless of gender. Analysis showed that musculoskeletal pain immediately after infection is observed more in cases with comorbid diseases (p<0.001), hypertension (p<0.001), pulmonary involvement (p=0.002) and hospitalization due to COVID-19 (p<0.001). It was determined that the incidence of pain seen immediately after infection increased as the number of comorbidities increased (p<0.001). In conjunction with this, persistent pain after COVID-19 infection were more common in those with osteoarthritis (p=0.039).Conclusion: Elderly patients may develop musculoskeletal pain in multiple body sites after COVID-19, which is primarily related to presence and number of comorbidities, hospitalization and pulmonary involvement. The long-term consequences of COVID-19 on musculoskeletal health are still being studied, and further research is needed to fully understand the extent and duration of these effects.