Journal of Medical Council of Iran
Volume 43 - Series of Sessions on Post-Acute COVID-19 Syndrome
jmciri 2025, 43 - Series of Sessions on Post-Acute COVID-19 Syndrome: 103-111 |
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Mami S, Pourgharib Shah M H, Assadiasl S, Zolfaghari M, Soleimanifar N, Esteghamati A, et al . Musculoskeletal complications after COVID-19. jmciri 2025; 43 (S1) :103-111
URL: http://jmciri.ir/article-1-3454-en.html
URL: http://jmciri.ir/article-1-3454-en.html
Somayeh Mami 
, Mohammad Hossein Pourgharib Shah , Sara Assadiasl , Mohammadali Zolfaghari , Narjes Soleimanifar , Alireza Esteghamati , Abdolrahman Rostamian , Ramin Kordi , Mohammad Hossein Nicknam
, Mohammad Hossein Pourgharib Shah , Sara Assadiasl , Mohammadali Zolfaghari , Narjes Soleimanifar , Alireza Esteghamati , Abdolrahman Rostamian , Ramin Kordi , Mohammad Hossein Nicknam
Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran
Abstract: (26 Views)
Background: COVID-19 is a systemic disease that, in some individuals, leads to post-COVID syndrome (Long COVID)—a chronic condition characterized by symptoms such as fatigue, myalgia, arthralgia, and low back pain. These musculoskeletal manifestations arise from complex pathophysiological mechanisms, including direct infection of muscle and joint cells via ACE2/TMPRSS2 receptors, activation of autoimmune responses (targeting muscle and cartilage), T-lymphocyte dysregulation (reduced Treg and elevated TH17 cells), chronic inflammation driven by cytokines such as IL-6 and TNF-α, mitochondrial dysfunction, microglial activation in the central nervous system, and epigenetic modifications that collectively sustain a state of chronic immune activation.
Results: Studies have consistently demonstrated that musculoskeletal symptoms are highly prevalent among Long COVID patients. In an Iranian study, 99% of patients reported at least one musculoskeletal symptom, and 50% experienced low back pain. Reduced physical activity, obesity, sleep disturbances, and psychological conditions—further exacerbate these symptoms. Conversely, structured rehabilitation programs incorporating guided exercise, respiratory physiotherapy, and strengthening exercises have led to significant improvements in cardiorespiratory function, muscle strength, and overall quality of life.
Conclusion: Musculoskeletal disorders in post-COVID syndrome result from a multifactorial interplay of inflammatory, immunological, and metabolic pathways. Regular exercise, patient education, psychological counseling, and management of comorbid factors (such as obesity and sleep disorders) are integral components of effective patient care.
Results: Studies have consistently demonstrated that musculoskeletal symptoms are highly prevalent among Long COVID patients. In an Iranian study, 99% of patients reported at least one musculoskeletal symptom, and 50% experienced low back pain. Reduced physical activity, obesity, sleep disturbances, and psychological conditions—further exacerbate these symptoms. Conversely, structured rehabilitation programs incorporating guided exercise, respiratory physiotherapy, and strengthening exercises have led to significant improvements in cardiorespiratory function, muscle strength, and overall quality of life.
Conclusion: Musculoskeletal disorders in post-COVID syndrome result from a multifactorial interplay of inflammatory, immunological, and metabolic pathways. Regular exercise, patient education, psychological counseling, and management of comorbid factors (such as obesity and sleep disorders) are integral components of effective patient care.
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