A case report of a patient with COVID-19 infection and widespread heterotopic ossification

Abstract

Since the beginning of the novel coronavirus disease-2019 (COVID-19) pandemic, physical medicine and rehabilitation specialists have played an important role in fighting this disease apart from the pulmonary rehabilitation. As a high number of patients have needed immobilization and intensive care unit (ICU) treatment, many complications have emerged inevitably. Heterotopic ossification (HO) is one of these complications. Herein, we present a case of young male patient who had widespread HO in his shoulders, elbows, and hips. Although he managed to survive, he still has difficulty in ambulation and daily living activities. Given the continuing high prevalence of COVID-19, many patients would need immobilization and ICU treatment. Therefore, causes of HO should be scrutinized, physicians and caregivers need to raise vigilance, and comprehensive protective measures should be put in place. On the other hand, as HO is used to be diagnosed quite frequently in the patients with neurological diseases, diagnosis of HO in the COVID-19 patients should not automatically be linked to the stay in the ICU. Yet, it is a fact that impaired immune response is prevalent both in COVID-19 and HO. The correlation between COVID-19 and HO is remarkable, but further research is needed to establish a causal relationship.