COVID-19 Can Cause the Body to Attack Itself

Muscle soreness and achy joints are common symptoms among COVID-19 patients. But for some people, symptoms are more severe, long lasting and even bizarre, including rheumatoid arthritis flares, autoimmune myositis or “COVID toes.”

A new Northwestern Medicine study has, for the first time, confirmed and illustrated the causes of these symptoms through radiological imaging.

“We’ve realized that the COVID virus can trigger the body to attack itself in different ways, which may lead to rheumatological issues that require lifelong management,” said corresponding author Dr. Swati Deshmukh.

“Many patients with COVID-related musculoskeletal disorders recover, but for some individuals, their symptoms become serious, are deeply concerning to the patient or impact their quality of life, which leads them to seek medical attention and imaging,” said Deshmukh, an assistant professor of musculoskeletal radiology at Northwestern University Feinberg School of Medicine. “That imaging allows us to see if COVID-related muscle and joint pain, for example, are not just body aches similar to what we see from the flu but something more insidious.”

What does the imaging look like?

“We might see edema and inflammatory changes of the tissues, hematomas or devitalized tissue,” Deshmukh said. “In some patients, the nerves are injured and in others, the problem is impaired blood flow.”

“I think it’s important to differentiate between what the virus causes directly and what it triggers the body to do,” Deshmukh said. “It’s important for doctors to know what’s happening in order to treat correctly.”

“Some doctors request imaging for patients with ‘COVID toes,’ for example, but there wasn’t any literature on imaging of foot and soft tissue complications of COVID,” Deshmukh said. “How do you find something if you’re unsure of what to look for? So in our paper, we discuss the various types of musculoskeletal abnormalities that radiologists should look for and provide imaging examples.”

Sources:

Santhoshini Leela Ramani, Jonathan Samet, Colin K. Franz, Christine Hsieh, Cuong V. Nguyen, Craig Horbinski, Swati Deshmukh. Musculoskeletal involvement of COVID-19: review of imaging. Skeletal Radiology, Feb. 18, 2021; DOI: 10.1007/s00256-021-03734-7

Northwestern University. “Radiological images confirm ‘COVID-19 can cause the body to attack itself’: Imaging illustrates severity, long-term prognosis of COVID-19-related muscle, joint pain.” ScienceDaily. ScienceDaily, 18 February 2021. <www.sciencedaily.com/releases/2021/02/210217151116.htm>.

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