Investigating the Relationship Between Musculoskeletal Post-COVID Sequelae and Acute COVID-19 Characteristics and Co-morbidities

Post-acute COVID Syndrome (PACS), also known as Long COVID refers to the persistence of symptoms after acute COVID infection and there is yet to be a strong scientific consensus on how exactly it may be characterized. Musculoskeletal (MSK) symptoms such as myalgia, arthralgia and fatigue/muscle weakness are some of the most frequently reported symptoms of PACS. Research indicates that the severity of post-COVID sequelae observed in patients is associated with the presence of pre-existing comorbidities. Some literature also speculates that hospitalization and ventilation may play a role in the occurrence of PACS symptoms. The proposed research aims to investigate the relationship between musculoskeletal post-COVID sequelae and the presence of pre-existing comorbidities in adults who were confirmed positive for COVID-19. The study will be a retrospective cohort study that utilizes clinical data from the National COVID Cohort Collaborative (N3C) data enclave on adult patients in the United States who have been diagnosed with COVID-19. Sex-specific multivariate logistic regression models adjusting for baseline covariates will be utilized to test associations between musculoskeletal symptoms and both the comorbidities and the characteristics of COVID-19 infection (e.g severity, duration, and care). Additionally, a survival analysis will be used to analyze time to the occurrence of MSK symptoms, adjusting for baseline covariates. Primary outcomes will be incident musculoskeletal post-acute COVID sequelae including myalgia, arthralgia, and fatigue. Through investigating this relationship, the proposed research aims to fill in some of the many knowledge gaps surrounding COVID-19 infection, particularly, its longer-term health implications.