A Pilot Case-Control Study of Muscle and Bone Health Status in Patients Who Have Recovered From COVID-19 Infection

Background: Coronavirus disease 2019 (COVID-19), resulting from the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), affects various bodily systems, including the heart, central nervous system, muscles, and bones, all of which harbor angiotensin-converting enzyme 2 (ACE-2) receptors similar to those in the respiratory system. However, research on the inflammatory response and its impact on systems such as the musculoskeletal one is relatively scarce. Our study aimed to investigate bone and muscle metrics as well as handgrip strength in individuals who recuperated from COVID-19 infection.

Methods: The pilot case-control study was conducted from June 2021 to September 2022, involving 25 adult patients aged 18-60 years who had recovered from COVID-19 infection, alongside 25 age- and gender-matched controls. Participants were recruited from a tertiary care hospital in Pune, and data on demographics, anthropometry, medical history, diet, and physical activity were recorded using standardized questionnaires. Dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) were used to assess bone and muscle parameters, whereas a handgrip dynamometer was used to measure muscle strength. Statistical analysis was performed using SPSS version 26.0 (IBM Corp., Armonk, NY).

Results: Post-COVID-19 recovered female patients exhibited lower lean mass, muscle density, and handgrip strength, alongside higher body fat levels.

Conclusion: Lean mass, muscle density, and handgrip strength were lower and body fat was higher in post-COVID-19 recovered females, thus indicating the need to focus on improving the musculoskeletal health of females post-hospitalization due to a serious illness such as COVID-19 infection.