The Impacts of COVID-19 on Musculoskeletal Health

Overview

Journal Curr Osteoporos Rep

Publisher Current Science

Specialties Endocrinology
Orthopedics

Date 2022 Jun 20

PMID 35723777

Authors

Olatundun D Awosanya

Ushashi C Dadwal

Erik A Imel

Qigui Yu

Melissa A Kacena

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: Although COVID-19 was originally characterized as a respiratory disease, recent findings have shown lingering side effects in those who have recovered, and much is still unknown about the long-term consequences of the illness. Thus, the potential of unearthing multi-system dysfunction is high, with current data revealing significant impacts on musculoskeletal health.

Recent Findings: Multiple animal models of COVID-19 infection have revealed significant post-infection bone loss at several different skeletal sites. While how this loss occurred is unknown, this current review discusses the primary bone loss studies, and examines the possible mechanisms of action including: direct infection of bone marrow macrophages or hematopoietic progenitors, a proinflammatory response as a result of the COVID-19 induced cytokine storm, and/or a result of hypoxia and oxidative stress. This review will further examine how therapeutics used to treat COVID-19 affect the skeletal system. Finally, this review will examine the possible consequence that delayed care and limited healthcare accessibility has on musculoskeletal-related patient outcomes. It is important to investigate the potential impact COVID-19 infection has on musculoskeletal health.

Citing Articles

SARS-CoV-2 Impairs Osteoblast Differentiation Through Spike Glycoprotein and Cytokine Dysregulation.

Freiberger R, Lopez C, Jarmoluk P, Palma M, Cevallos C, Sviercz F Viruses. 2025; 17(2).

PMID: 40006897 PMC: 11860324. DOI: 10.3390/v17020143.

The Role of the Six-Minute Walk Test in the Functional Evaluation of the Efficacy of Rehabilitation Programs After COVID-19.

Tache-Codreanu D, Bobocea L, David I, Burcea C, Sporea C Life (Basel). 2024; 14(11).

PMID: 39598312 PMC: 11595584. DOI: 10.3390/life14111514.

Long-term effects of COVID-19 infection on bone mineral density.

Wang Z, Li Z, Shen Y, Qian S, Tang M, He J J Glob Health. 2024; 14:05029.

PMID: 39421935 PMC: 11487469. DOI: 10.7189/jogh.14.05029.

Clinical outcomes of COVID-19 infection in patients with osteoporosis: a nationwide cohort study in Korea using the common data model.

Ahn S, Seo S, Jung C, Yu D, Kim Y, Cho Y Sci Rep. 2024; 14(1):17738.

PMID: 39085367 PMC: 11291711. DOI: 10.1038/s41598-024-68356-0.

Connective tissue disorders in COVID-19: Reply to "People with a connective tissue disorder may be especially vulnerable to the endothelial damage that characterizes long COVID due to the fragility of their vasculature and slow wound healing".

Wu X, Novakovic V, Shi J Angiogenesis. 2024; 27(2):125-127.

PMID: 38532037 DOI: 10.1007/s10456-024-09915-x.

References

Nakane M . Biological effects of the oxygen molecule in critically ill patients. J Intensive Care. 2020; 8(1):95. PMC: 7734465. DOI: 10.1186/s40560-020-00505-9. View

Apte R, Chen D, Ferrara N . VEGF in Signaling and Disease: Beyond Discovery and Development. Cell. 2019; 176(6):1248-1264. PMC: 6410740. DOI: 10.1016/j.cell.2019.01.021. View

Lee J, Kim H, Kim K, Jin W, Lee S, Kim H . CXCL10 promotes osteolytic bone metastasis by enhancing cancer outgrowth and osteoclastogenesis. Cancer Res. 2012; 72(13):3175-86. DOI: 10.1158/0008-5472.CAN-12-0481. View

Heimfarth L, Serafini M, Martins-Filho P, Quintans J, Quintans-Junior L . Drug repurposing and cytokine management in response to COVID-19: A review. Int Immunopharmacol. 2020; 88:106947. PMC: 7457938. DOI: 10.1016/j.intimp.2020.106947. View

Mudd P, Crawford J, Turner J, Souquette A, Reynolds D, Bender D . Distinct inflammatory profiles distinguish COVID-19 from influenza with limited contributions from cytokine storm. Sci Adv. 2020; 6(50). PMC: 7725462. DOI: 10.1126/sciadv.abe3024. View

Jain A, Chaurasia R, Sengar N, Singh M, Mahor S, Narain S . Analysis of vitamin D level among asymptomatic and critically ill COVID-19 patients and its correlation with inflammatory markers. Sci Rep. 2020; 10(1):20191. PMC: 7677378. DOI: 10.1038/s41598-020-77093-z. View

Vasheghani M, Jannati N, Baghaei P, Rezaei M, Aliyari R, Marjani M . The relationship between serum 25-hydroxyvitamin D levels and the severity of COVID-19 disease and its mortality. Sci Rep. 2021; 11(1):17594. PMC: 8413335. DOI: 10.1038/s41598-021-97017-9. View

Tat S, Padrines M, Theoleyre S, Heymann D, Fortun Y . IL-6, RANKL, TNF-alpha/IL-1: interrelations in bone resorption pathophysiology. Cytokine Growth Factor Rev. 2004; 15(1):49-60. DOI: 10.1016/j.cytogfr.2003.10.005. View

Hartmann K, Koenen M, Schauer S, Wittig-Blaich S, Ahmad M, Baschant U . Molecular Actions of Glucocorticoids in Cartilage and Bone During Health, Disease, and Steroid Therapy. Physiol Rev. 2016; 96(2):409-47. DOI: 10.1152/physrev.00011.2015. View

10.

Cummings S, Ferrari S, Eastell R, Gilchrist N, Jensen J, McClung M . Vertebral Fractures After Discontinuation of Denosumab: A Post Hoc Analysis of the Randomized Placebo-Controlled FREEDOM Trial and Its Extension. J Bone Miner Res. 2017; 33(2):190-198. DOI: 10.1002/jbmr.3337. View

11.

Bone H, Bolognese M, Yuen C, Kendler D, Miller P, Yang Y . Effects of denosumab treatment and discontinuation on bone mineral density and bone turnover markers in postmenopausal women with low bone mass. J Clin Endocrinol Metab. 2011; 96(4):972-80. DOI: 10.1210/jc.2010-1502. View

12.

Griffith J . Musculoskeletal complications of severe acute respiratory syndrome. Semin Musculoskelet Radiol. 2011; 15(5):554-60. DOI: 10.1055/s-0031-1293500. View

13.

Orford N, Pasco J, Kotowicz M . Osteoporosis and the Critically Ill Patient. Crit Care Clin. 2019; 35(2):301-313. DOI: 10.1016/j.ccc.2018.11.006. View

14.

Casciato D, Yancovitz S, Thompson J, Anderson S, Bischoff A, Ayres S . Diabetes-Related Major and Minor Amputation Risk Increased During the COVID-19 Pandemic. J Am Podiatr Med Assoc. 2020; 113(2). DOI: 10.7547/20-224. View

15.

Kox M, Waalders N, Kooistra E, Gerretsen J, Pickkers P . Cytokine Levels in Critically Ill Patients With COVID-19 and Other Conditions. JAMA. 2020; . PMC: 7489366. DOI: 10.1001/jama.2020.17052. View

16.

Kobayashi K, Takahashi N, Jimi E, Udagawa N, Takami M, Kotake S . Tumor necrosis factor alpha stimulates osteoclast differentiation by a mechanism independent of the ODF/RANKL-RANK interaction. J Exp Med. 2000; 191(2):275-86. PMC: 2195746. DOI: 10.1084/jem.191.2.275. View

17.

Olney R . Mechanisms of impaired growth: effect of steroids on bone and cartilage. Horm Res. 2009; 72 Suppl 1:30-5. DOI: 10.1159/000229761. View

18.

Haudenschild A, Christiansen B, Orr S, Ball E, Weiss C, Liu H . Acute bone loss following SARS-CoV-2 infection in mice. J Orthop Res. 2023; 41(9):1945-1952. PMC: 10440245. DOI: 10.1002/jor.25537. View

19.

Viswanathan V, Nachimuthu S . Major Lower-Limb Amputation During the COVID Pandemic in South India. Int J Low Extrem Wounds. 2021; 22(3):475-479. DOI: 10.1177/15347346211020985. View

20.

Kume K, Amano K, Yamada S, Kanazawa T, Ohta H, Hatta K . The effect of tocilizumab on bone mineral density in patients with methotrexate-resistant active rheumatoid arthritis. Rheumatology (Oxford). 2014; 53(5):900-3. DOI: 10.1093/rheumatology/ket468. View