A Study Protocol to Assess Musculoskeletal Problems in Post Covid-19 Subjects

Background: The severe acute respiratory syndrome coronavirus 2 is the cause of the global pandemic known as COVID-19 (SARS-COV-2), which has captivated the entire world. It has been demonstrated that the coronavirus interacts with the angiotensin-converting enzyme-2 (ACE-2) present in skeletal muscles, increasing its susceptibility to direct viral invasion. The fibrotic activity of muscle fibroblasts increases, aggravating the inflammatory response. The participants exhibit musculoskeletal complaints, including fatigue, myalgia, arthralgia, muscle weakness, decreased bone mineral density, and anomalies in soft tissues. Further examination of COVID-19 individuals showed elevated levels of creatine phosphokinase, myalgia, and arthritic changes, including myositis. A long-term study found that the most common musculoskeletal complaints between two weeks and one month after hospitalization were myalgia, arthralgia, and fatigue. The current study's goal is to analyze various musculoskeletal concerns in COVID-19 participants.

Outcome Measures: A standard Nordic musculoskeletal questionnaire will be taken for all subjects. Depending on the problem and joint involved outcome measures like NPDI, SPADI, DASH, OLBDQ, HHS, WOMAC, FADI, CFS, LEFS, and FAS will be used.

Statistical Analysis: Descriptive statistical analysis like mean, and standard deviation will be done by using SPSS’s latest version software by taking the help of a Biostatistician after ensuring the normal distribution and analysis. To find out the association between two variables Fisher’s exact test and Pearson chi-square test will be used.

Results: The results of this study will also be important for subjects affected with COVID-19 symptoms to better understand their long-term musculoskeletal problems with a duration of more than 3 months from affection with the virus which may or may not affect their functional performance and physical activity levels.

Conclusion: This study will be helpful in finding the prevalence of musculoskeletal problems among post-COVID-19 subjects. If any particular symptoms are found to be more prominent strategies to cope and manage those symptoms in COVID-19 subjects can be developed in the future by doing further research.

Clinical Trial Registration: The study is registered with the Clinical Trials Registry- India (CTRI), with the registration number for the trial being CTRI/2022/08/ 044661.