Impacts of COVID-19 on the immune, neuromuscular, and musculoskeletal systems and rehabilitation

Abstract

The new coronavirus, which causes the infectious disease named COVID-19 by the World Health Organization (WHO), was notified in 2020 in China. The main clinical manifestations in infected patients are fever, cough and dyspnoea. These patients are prone to developing cardiac changes, diffuse myopathy, decreased pulmonary function, decreased inspiratory muscle strength, and a deterioration in functional capacity. Thus, it is expected that patients affected by COVID-19 will suffer musculoskeletal consequences as a result of the inflammatory process and loss of muscle mass caused by immobility, generating motor incapacities that are not yet quantifiable. It is important to understand the clinical implications caused by COVID-19, in order to have better rehabilitation strategies for these patients. The aim of this study was to conduct a reflective analysis of the impact of COVID-19 on the immune, neuromuscular and musculoskeletal systems, and its rehabilitation process. This is a reflexive analysis, developed in the Laboratory for the Study of Movement of the Institute of Orthopaedics’ and Traumatology, at the Universidade de São Paulo School of Medicine, SP, Brazil. In this analysis, we reflect on the following topics related to COVID-19: immunological mechanisms, impact on the neuromuscular and musculoskeletal systems, and the rehabilitation of patients. Level of evidence V; Opinion of the specialist.