Öz
Aim: Many studies have showed that myalgia is a common onset symptom in coronavirus disease 2019 (COVID-19). This study aimed to determine the frequency of muscle pain in patients followed with COVID-19 diagnosis, and to investigate the relationship between muscle pain and creatine kinase (CK), pH, lactate and lactate dehydrogenase (LDH) levels.
Material and Methods: One hundred ten patients diagnosed with COVID-19 in our hospital were included retrospectively in this study. Presence of myalgia at the time of admission and on the 14th day of control were investigated. The first admission laboratory findings, 3rd day CK values and 14th day control CK values of all patients were recorded retrospectively from their files.
Results: The study included 110 patients diagnosed with COVID-19. Fifty patients (45.5%) had muscle pain at the time of admission, and it was one of the most common musculoskeletal complaints. High CK results were obtained in 48 (43.6%) of the 110 patients at the time of admission. Thirty-two (66.7%) of 48 patients with high CK had muscle pain (p<0.001). In the patients with muscle pain, the CK levels observed on 1st, 3rd, and 14th day of the disease were found to be significantly higher than in those without muscle pain (p<0.001, p=0.003, p=0.029). No significant relationship was found between complaints of muscle pain and lactate, pH, and LDH values.
Conclusion: Since some patients may only present with musculoskeletal symptoms such as myalgia, it is important that clinicians consider COVID-19 in patients presenting with myalgia and high CK levels.
Anahtar Kelimeler
Kaynakça
- Zheng F, Tang W, Li H, Huang YX, Xie Y, Zhou ZG. Clinical characteristics of 161 cases of corona virus disease 2019 (COVID-19) in Changsha. Eur Rev Med Pharmacol Sci. 2020;24(6):3404-10.
- Zhao XY, Xu XX, Yin HS, Hu QM, Xiong T, Tang YY, et al. Clinical characteristics of patients with 2019 coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study. BMC Infect Dis. 2020;20(1):311.
- Lippi G, Wong J, Henry BM. Myalgia may not be associated with severity of coronavirus disease 2019 (COVID-19). World J Emerg Med. 2020;11(3):193-4.
- Hamming I, Timens W, Bulthuis MLC, Lely AT, Navis GJ, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203(2):631-7.
- Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271-80.
- Li W, Moore MJ, Vasilieva N, Sui J, Wong SK, Berne MA, et al. Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus. Nature. 2003;426(6965):450-4.
- Cure E, Cumhur Cure M. Comment on “should COVID-19 concern nephrologists? Why and to what extent? The emerging impasse of angiotensin blockade”. Nephron. 2020;144(5):251-2.
- Echeverría-Rodríguez O, Gallardo-Ortíz IA, Del Valle-Mondragón L, Villalobos-Molina R. Angiotensin-(1-7) participates in enhanced skeletal muscle insulin sensitivity after a bout of exercise. J Endocr Soc. 2020;4(2):bvaa007.
- Kucuk A, Cumhur Cure M, Cure E. Can COVID-19 cause myalgia with a completely different mechanism? A hypothesis. Clin Rheumatol. 2020;39(7):2103-4.
- Queme LF, Ross JL, Jankowski MP. Peripheral mechanisms of ischemic myalgia. Front Cell Neurosci. 2017;11:419.
- Jiang X, Coffee M, Bari A, Wang J, Jiang X, Huang J, et al. Towards an artificial intelligence framework for data-driven prediction of coronavirus clinical severity. Comput Mater Contin. 2020;63(1):537-51.
- Drożdżal S, Rosik J, Lechowicz K, Machaj F, Szostak B, Majewski P, et al. COVID-19: Pain management in patients with SARS-CoV-2 infection-molecular mechanisms, challenges, and perspectives. Brain Sci. 2020;10(7):465.
- Ding Y, Wang H, Shen H, Li Z, Geng J, Han H, et al. The clinical pathology of severe acute respiratory syndrome (SARS): a report from China. J Pathol. 2003;200(3):282-9.
- Hsiao CH, Chang MF, Hsueh PR, Su IJ. Immunohistochemical study of severe acute respiratory syndrome-associated coronavirus in tissue sections of patients. J Formos Med Assoc. 2005;104(3):150-6.
- Manjavachi MN, Motta EM, Marotta DM, Leite DFP, Calixto JB. Mechanisms involved in IL-6-induced muscular mechanical hyperalgesia in mice. Pain. 2010;151(2):345-55.
- Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5):2620-9.
- Pedersen SF, Ho YC. SARS-CoV-2: a storm is raging. J Clin Invest. 2020;130(5):2202-5.
- Borku Uysal BB, Ikitimur H, Yavuzer S, Islamoglu MS, Cengiz M. Case report: a COVID-19 patient presenting with mild rhabdomyolysis. Am J Trop Med Hyg. 2020;103(2):847-50.
- Ponti G, Maccaferri M, Ruini C, Tomasi A, Ozben T. Biomarkers associated with COVID-19 disease progression. Crit Rev Clin Lab Sci. 2020;57(6):389-99.
- Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46(5):846-8.
- Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81.
- Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62.
- Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
- Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurological manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. 2020;77(6):683-90.
- Karadaş Ö, Öztürk B, Sonkaya AR. A prospective clinical study of detailed neurological manifestations in patients with COVID-19. Neurol Sci. 2020;41(8):1991-5.
Öz
Amaç: Birçok çalışma miyaljinin koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19)’da sık görülen bir başlangıç semptomu olduğunu göstermiştir. Bu çalışmada COVID-19 tanısıyla takip edilen hastalarda kas ağrısı sıklığının belirlenmesi ve kas ağrısı ile kreatin kinaz (creatine kinase, CK), pH, laktat ve laktat dehidrogenaz (LDH) düzeyleri arasındaki ilişkisinin araştırılması amaçlandı.
Gereç ve Yöntemler: Bu çalışmaya hastanemizde COVID-19 tanısı almış olan 110 hasta geriye dönük olarak dahil edildi. Başvuru sırasında ve 14. gün kontrolde miyalji yakınması olup olmadığı incelendi. Tüm hastaların ilk başvurudaki laboratuvar bulguları, 3. gün CK değerleri ve 14. gün kontrolündeki CK değerleri dosyalarından geriye dönük olarak kaydedildi.
Bulgular: COVID-19 tanısı almış 110 hasta çalışmaya alındı. Elli hastada (%45,5) başvuru anında kas ağrısı vardı ve en sık görülen kas iskelet sistemi şikâyetlerinden biriydi. Yüz on hastanın 48'inde (%43,6) başvuru anında CK yüksekliği saptandı. CK yüksekliği saptanan 48 hastanın 32'sinde (%66,7) kas ağrısı vardı (p<0,001). Kas ağrısı olan hastalarda 1., 3. ve 14. günde bakılan CK düzeyleri kas ağrısı şikayeti olmayanlara göre anlamlı derecede yüksek bulundu (p<0,001; p=0,003; p=0,029). Kas ağrısı yakınması ile laktat, pH ve LDH değerleri arasında anlamlı ilişki bulunmadı.
Sonuç: Başvuru sırasında yalnızca miyalji gibi kas iskelet sistem semptomları bulunan hastalar olabileceğinden, miyalji ile başvuran ve CK yüksekliği saptanan hastalarda COVID-19’un akılda tutulması önem arz etmektedir.
Anahtar Kelimeler
Kaynakça
- Zheng F, Tang W, Li H, Huang YX, Xie Y, Zhou ZG. Clinical characteristics of 161 cases of corona virus disease 2019 (COVID-19) in Changsha. Eur Rev Med Pharmacol Sci. 2020;24(6):3404-10.
- Zhao XY, Xu XX, Yin HS, Hu QM, Xiong T, Tang YY, et al. Clinical characteristics of patients with 2019 coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study. BMC Infect Dis. 2020;20(1):311.
- Lippi G, Wong J, Henry BM. Myalgia may not be associated with severity of coronavirus disease 2019 (COVID-19). World J Emerg Med. 2020;11(3):193-4.
- Hamming I, Timens W, Bulthuis MLC, Lely AT, Navis GJ, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203(2):631-7.
- Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271-80.
- Li W, Moore MJ, Vasilieva N, Sui J, Wong SK, Berne MA, et al. Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus. Nature. 2003;426(6965):450-4.
- Cure E, Cumhur Cure M. Comment on “should COVID-19 concern nephrologists? Why and to what extent? The emerging impasse of angiotensin blockade”. Nephron. 2020;144(5):251-2.
- Echeverría-Rodríguez O, Gallardo-Ortíz IA, Del Valle-Mondragón L, Villalobos-Molina R. Angiotensin-(1-7) participates in enhanced skeletal muscle insulin sensitivity after a bout of exercise. J Endocr Soc. 2020;4(2):bvaa007.
- Kucuk A, Cumhur Cure M, Cure E. Can COVID-19 cause myalgia with a completely different mechanism? A hypothesis. Clin Rheumatol. 2020;39(7):2103-4.
- Queme LF, Ross JL, Jankowski MP. Peripheral mechanisms of ischemic myalgia. Front Cell Neurosci. 2017;11:419.
- Jiang X, Coffee M, Bari A, Wang J, Jiang X, Huang J, et al. Towards an artificial intelligence framework for data-driven prediction of coronavirus clinical severity. Comput Mater Contin. 2020;63(1):537-51.
- Drożdżal S, Rosik J, Lechowicz K, Machaj F, Szostak B, Majewski P, et al. COVID-19: Pain management in patients with SARS-CoV-2 infection-molecular mechanisms, challenges, and perspectives. Brain Sci. 2020;10(7):465.
- Ding Y, Wang H, Shen H, Li Z, Geng J, Han H, et al. The clinical pathology of severe acute respiratory syndrome (SARS): a report from China. J Pathol. 2003;200(3):282-9.
- Hsiao CH, Chang MF, Hsueh PR, Su IJ. Immunohistochemical study of severe acute respiratory syndrome-associated coronavirus in tissue sections of patients. J Formos Med Assoc. 2005;104(3):150-6.
- Manjavachi MN, Motta EM, Marotta DM, Leite DFP, Calixto JB. Mechanisms involved in IL-6-induced muscular mechanical hyperalgesia in mice. Pain. 2010;151(2):345-55.
- Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5):2620-9.
- Pedersen SF, Ho YC. SARS-CoV-2: a storm is raging. J Clin Invest. 2020;130(5):2202-5.
- Borku Uysal BB, Ikitimur H, Yavuzer S, Islamoglu MS, Cengiz M. Case report: a COVID-19 patient presenting with mild rhabdomyolysis. Am J Trop Med Hyg. 2020;103(2):847-50.
- Ponti G, Maccaferri M, Ruini C, Tomasi A, Ozben T. Biomarkers associated with COVID-19 disease progression. Crit Rev Clin Lab Sci. 2020;57(6):389-99.
- Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46(5):846-8.
- Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81.
- Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62.
- Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
- Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurological manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. 2020;77(6):683-90.
- Karadaş Ö, Öztürk B, Sonkaya AR. A prospective clinical study of detailed neurological manifestations in patients with COVID-19. Neurol Sci. 2020;41(8):1991-5.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Kasım 2020 |
| Gönderilme Tarihi | 4 Ağustos 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 22 Sayı: Special Issue |
Kaynak Göster
Cited By
TRP channels in COVID-19 disease: Potential targets for prevention and treatment
Chemico-Biological Interactions
https://doi.org/10.1016/j.cbi.2021.109567
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