Evaluation of the prevalence of new-onset musculoskeletal symptoms in patients hospitalized for severe SARS-CoV-2 infection during the first two COVID waves in France: A descriptive analysis of the clinical data warehouse of 39 hospitals in France

OBJECTIVE: To determine the prevalence of musculoskeletal (MSK) symptoms appearing after a SARS-CoV-2 infection. METHODS: This was an observational cohort based on data available at the Assistance publique–Hôpitaux de Paris (AP–HP) Clinical Data Warehouse (which includes data of more than 11 million patients treated in the 39 hospitals from AP–HP). The data collected included both ICD-10 codes in discharge summaries, and recurring wording expressions search on medical electronic documents. To be included in the analysis, patients had to have a positive RT-PCR for SARS-CoV-2 and be admitted in any department of AP–HP. Patients with previous history of any MSK condition were excluded. MSK conditions were considered if occurring up to 90 days after the positive RT-PCR. Demographics and disease characteristics including treatment were compared in both groups (MSK yes/no) by t-test or Chi(2) test, accordingly. RESULTS: In total, 17,771 patients had a positive SARS-CoV-2 RT-PCR at APHP and were admitted in any department of AP–HP. Among them, 15,601 had no previous history of MSK condition and among them, 1370 (8.8%) presented with MSK symptoms after the viral infection. The most prevalent MSK symptoms were back pain (32.9%), followed by arthralgia (29.9%), radicular pain (20.2%) and arthritis (22.8%). Patients with MSK symptoms (MSK+) were older (67 y vs. 64 y, P < 0.01), more frequently obese (29% vs. 25%, P = 0.03), hypertensive (34% vs. 30%, P < 0.01) and with diabetes (21% vs. 18%, P < 0.01). Treatment for SARS-CoV-2 was slightly different in both groups, with higher corticosteroids (40.7% vs. 29.0%, P < 0.01), antivirals (21.5% vs. 15.3%, P < 0.01) and immunosuppressors (8.5% vs. 4.5%, P < 0.01) prescription rates in the MSK+ group. CONCLUSION: MSK symptoms occurred in almost 9% of patients admitted to the hospital after a SARS-CoV-2 infection, particularly in older and more comorbid patients. Further analysis evaluating whether these symptoms remain over time are needed.