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      The Musculoskeletal Involvement After Mild to Moderate COVID-19 Infection

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          Abstract

          COVID-19, a disease caused by the novel coronavirus SARS-CoV-2, has been drastically affecting the daily lives of millions of people. COVID-19 is described as a multiorgan disease that affects not only the respiratory tract of infected individuals, but it has considerable effects on the musculoskeletal system, causing excessive fatigue, myalgia, arthralgia, muscle weakness and skeletal muscle damage. These symptoms can persist for months, decreasing the quality of life of numerous individuals. Curiously, most studies in the scientific literature focus on patients who were hospitalized due to SARS-CoV-2 infection and little is known about the mechanism of action of COVID-19 on skeletal muscles, especially of individuals who had the mild to moderate forms of the disease (non-hospitalized patients). In this review, we focus on the current knowledge about the musculoskeletal system in COVID-19, highlighting the lack of researches investigating the mild to moderate cases of infection and pointing out why it is essential to care for these patients. Also, we will comment about the need of more experimental data to assess the musculoskeletal manifestations on COVID-19-positive individuals.

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          Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention

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            The trinity of COVID-19: immunity, inflammation and intervention

            Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Alongside investigations into the virology of SARS-CoV-2, understanding the fundamental physiological and immunological processes underlying the clinical manifestations of COVID-19 is vital for the identification and rational design of effective therapies. Here, we provide an overview of the pathophysiology of SARS-CoV-2 infection. We describe the interaction of SARS-CoV-2 with the immune system and the subsequent contribution of dysfunctional immune responses to disease progression. From nascent reports describing SARS-CoV-2, we make inferences on the basis of the parallel pathophysiological and immunological features of the other human coronaviruses targeting the lower respiratory tract — severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). Finally, we highlight the implications of these approaches for potential therapeutic interventions that target viral infection and/or immunoregulation.
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              Extrapulmonary manifestations of COVID-19

              Although COVID-19 is most well known for causing substantial respiratory pathology, it can also result in several extrapulmonary manifestations. These conditions include thrombotic complications, myocardial dysfunction and arrhythmia, acute coronary syndromes, acute kidney injury, gastrointestinal symptoms, hepatocellular injury, hyperglycemia and ketosis, neurologic illnesses, ocular symptoms, and dermatologic complications. Given that ACE2, the entry receptor for the causative coronavirus SARS-CoV-2, is expressed in multiple extrapulmonary tissues, direct viral tissue damage is a plausible mechanism of injury. In addition, endothelial damage and thromboinflammation, dysregulation of immune responses, and maladaptation of ACE2-related pathways might all contribute to these extrapulmonary manifestations of COVID-19. Here we review the extrapulmonary organ-specific pathophysiology, presentations and management considerations for patients with COVID-19 to aid clinicians and scientists in recognizing and monitoring the spectrum of manifestations, and in developing research priorities and therapeutic strategies for all organ systems involved.
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                Author and article information

                Contributors
                Journal
                Front Physiol
                Front Physiol
                Front. Physiol.
                Frontiers in Physiology
                Frontiers Media S.A.
                1664-042X
                18 March 2022
                2022
                18 March 2022
                : 13
                : 813924
                Affiliations
                Muscle Physiology and Biophysics Laboratory , Department of Physiological Sciences , Federal University of São Carlos (UFSCar) , São Carlos, Brazil
                Author notes

                Edited by: Bruno Bastide, Lille University of Science and Technology, France

                Reviewed by: Junaith S. Mohamed, University of Tennessee Health Science Center (UTHSC), United States

                Cipta Pramana, Universitas Wahid Hasyim, Indonesia

                *Correspondence: Patty K. dos Santos, patty_karina@ 123456outlook.com ; Anabelle S. Cornachione, cornachione@ 123456ufscar.br

                This article was submitted to Striated Muscle Physiology, a section of the journal Frontiers in Physiology

                Article
                813924
                10.3389/fphys.2022.813924
                9040683
                35492595
                16d356f3-4f46-4e2a-8648-3fe1286dc623
                Copyright © 2022 dos Santos, Sigoli, Bragança and Cornachione.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 12 November 2021
                : 01 March 2022
                Funding
                Funded by: Fundação de Amparo à Pesquisa do Estado de São Paulo , doi 10.13039/501100001807;
                Award ID: 2020/14172-1
                Funded by: Conselho Nacional de Desenvolvimento Científico e Tecnológico , doi 10.13039/501100003593;
                Categories
                Physiology
                Review

                Anatomy & Physiology
                covid-19,musculoskeletal system,mild to moderate covid-19,sars-cov-2,long covid,non-hospitalized individuals,muscle symptoms

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