Skeletal muscle injury in COVID infection: Frequency and patterns

Abstract

AbstractIntroduction/AimsLittle is known about skeletal muscle injury with coronavirus disease 2019 (COVID‐19). We estimate the frequency and explore the patterns of skeletal muscle injury in acute COVID‐19.MethodsA cohort of COVID patients with mild to moderate symptoms were evaluated in a COVID‐designated hospital between May and December 2021 and followed for 2 weeks. Skeletal muscle injury was assessed according to creatine kinase (CK) levels, Manual Muscle Test‐8 (MMT‐8) score, and the Health Assessment Questionnaire (HAQ) score. Injury was defined as CK >200 IU/L with an MMT‐8 score < 76. The association between such injury and severity and outcomes were evaluated using cross‐tabulations.ResultsTwo hundred fifty participants with a mean age of 50.2 years (SD: 17.2) were included. One hundred nine (43.6%) were women; 84 (34%) developed severe disease. Median CK levels were 91 IU/L (IQR 56–181). [Correction added on 17 November 2023, after first online publication: In the preceding sentence, the IQR was corrected from ‘56,181’.] Patients with weakness on the MMT‐8 (n = 247, 98.8%) and disability on the HAQ (n = 107; 42.8%) were common. Neck flexor muscles were prominently affected. Skeletal muscle injury was seen in 22.4% (95% CI: 17.4–28.1). There was no significant association between skeletal muscle injury and maximal severity of illness or short‐term outcomes. Disability increased over 14 days in most survivors (n = 172, 72.3%) and this was not seen in those with mild disease (OR: 0.4, 95% CI: 0.22–0.70).DiscussionSkeletal muscle injury appears to be common in people presenting with mild to moderate COVID infection.