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COVID-19 was declared as a pandemic on 11 March 2020 by the World Health Organization (WHO), and has currently affected more than 485 million people worldwide and caused more than 6 million of deaths (as of 31 March 2022). Musculoskeletal symptoms are common in patients with COVID-19. Many studies present the clinical aspects of COVID-19, but the involvement of the musculoskeletal system has not been deeply investigated yet. This narrative review aims to highlight the current understanding of the effect of COVID-19 on the musculoskeletal system and the potential damages caused by COVID-19 on skeletal muscles. We analyzed published reports on COVID-19-associated musculoskeletal symptoms. Literature search are performed with extensive filter of PubMed, Google Scholar, and Scopus. We identified case reports, case series, cohort studies, and meta-analyses. The last search was done on 31 March 2022. COVID-19 can cause range of musculoskeletal symptoms such as myalgia, fatigue, arthralgia, and muscle weakness. Increased LDH and anaerobic glycolysis in COVID-19 lead to an increase in lactate level in muscles, and this can cause hypoxia and ischemic muscle pain. COVID-19 patients with critical illness myopathy (CIM) and critical illness polyneuropathy (CIP) also tend to have difficulty weaning from a ventilator due to respiratory muscle weakness. The current therapeutics used in the management of COVID-19 patients can also cause musculoskeletal effects that clinicians should be aware of. The effective rehabilitation is critical in helping patients return to pre-infection mobility and function.
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