Musculoskeletal Symptoms Following COVID-19 Infection and Vaccination: An Observational Study

Authors

  • Marwan Hmoud Adwan Department of Medicine, Division of Rheumatology, The University of Jordan, Amman, Jordan
  • Sara O Rahhal Department of Medicine, Division of Rheumatology, The University of Jordan, Amman, Jordan
  • Jude J Abdulhameed Department of Medicine, Division of Rheumatology, The University of Jordan, Amman, Jordan
  • Ayman AbuHelal Department of Medicine, Division of Rheumatology, The University of Jordan, Amman, Jordan

DOI:

https://doi.org/10.35516/jmj.v59i4.2470

Keywords:

COVID-19, Coronavirus, vaccination, arthritis

Abstract

Background: The global pandemic caused by COVID-19 has led to numerous reports of musculoskeletal (MSK) symptoms occurring after infection or vaccination. However, the precise prevalence of MSK symptoms in individuals following COVID-19 infection/vaccination remains uncertain.

Methods: This observational study involved 46 patients who developed MSK symptoms after experiencing COVID-19 infection or vaccination.

Results: The study group comprised 37 females (80.4%) and 9 males (19.6%) with an average age of 48.6±12.4 years (median 47.5 years). Among the participants, 25 patients (54%) developed symptoms after infection, while 21 patients (46%) reported symptoms after vaccination. The duration of symptoms ranged from 2 to 65 weeks, and the onset of symptoms occurred between 1-182 days following infection/vaccination (median 7 days). The small joints of the hands and feet were the most frequently affected (50%), followed by the wrists (47.8%) and knees (41.3%). Notably, approximately 50% of cases experienced complete resolution of symptoms. Additionally, individuals with pre-existing arthritis may experience exacerbation of their symptoms following infection/vaccination.

Conclusion: This study reveals that MSK symptoms can manifest after COVID-19 infection/vaccination, with the small joints being the most commonly affected. These findings emphasize the importance of comprehending and monitoring MSK symptoms in individuals post-COVID-19 infection/vaccination to provide appropriate medical care and management.

References

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497-506.

Hasan LK, Deadwiler B, Haratian A, Bolia IK, Weber AE, Petrigliano FA. Effects of COVID-19 on the musculoskeletal system: clinician’s guide. Orthopedic Research and Reviews. 2021;13:141.

Cipollaro L, Giordano L, Padulo J, Oliva F, Maffulli N. Musculoskeletal symptoms in SARS-CoV-2 (COVID-19) patients. BioMed Central. 2020;15(1):178.

Pormohammad A, Zarei M, Ghorbani S, Mohammadi M, Razizadeh MH, Turner DL, et al. Efficacy and safety of COVID-19 vaccines: a systematic review and meta-analysis of randomized clinical trials. Vaccines. 2021;9(5):467.

Türk S, Öztürk Z, Karataş D, Gönüllü E. Inactivated COVID-19vaccine can induce reactive polyarthritis in older patients: report of two cases. Georgian Medical News. 2021(319):100-2.

Liew IY, Mak TM, Cui L, Vasoo S, Lim XR. A case of reactive arthritis secondary to coronavirus disease infection. Journal of Clinical Rheumatology. 2020;26(6):233.

AF M. Coronavirus Disease 19 (COVID-19) complicated with post-viral arthritis. Acta Reumatológica Portuguesa. 2020;45(4).

Hamming I, Timens W, Bulthuis M, Lely A, Navis Gv, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. The Journal of Pathology: A Journal of the Pathological Society of Great Britain and Ireland. 2004;203(2):631-7.

Mokuda S, Tokunaga T, Masumoto J, Sugiyama E. Angiotensin-converting enzyme 2, a SARS-CoV-2 receptor, is upregulated by interleukin 6 through STAT3 signaling in synovial tissues. The Journal of Rheumatology. 2020;47(10):1593-5.

Khosla SG, Nylen ES, Khosla R. Rhabdomyolysis in patients hospitalized with COVID-19 infection: five case series. Journal of Investigative Medicine. 2020;8:2324709620984603.

Adwan MH. An update on drug-induced arthritis. Rheumatology International. 2016;36(8):1089-97.

Ercolini A, Miller S. The role of infections in autoimmune disease. Clinical & Experimental Immunology. 2009;155(1):1-15.

Wraith DC, Goldman M, Lambert P-H. Vaccination and autoimmune disease: what is the evidence? The Lancet. 2003;362(9396):1659-66.

Slouma M, Abbes M, Mehmli T, Dhahri R, Metoui L, Gharsallah I, et al. Reactive arthritis occurring after COVID-19 infection: a narrative review. Infection. 2023;51(1):37-45.

Pal A, Roongta R, Mondal S, Sinha D, Sinhamahapatra P, Ghosh A, et al. Does post-COVID reactive arthritis exist? Experience of a tertiary care centre with a review of the literature. Reumatología Clínica. 2023;19(2):67-73.

Mukarram MS, Ishaq Ghauri M, Sethar S, Afsar N, Riaz A, Ishaq K. COVID-19: an emerging culprit of inflammatory arthritis. Case reports in rheumatology. .2021;2021:6610340.

Taha SI, Samaan SF, Ibrahim RA, El-Sehsah EM, Youssef MK. Post-COVID-19 arthritis: is it hyperinflammation or autoimmunity? European Cytokine Network. 2021;32(4):83-8.

Downloads

Published

2025-09-08

How to Cite

Adwan, M. H., Rahhal, S. O. ., Abdulhameed, J. J. ., & AbuHelal, A. . (2025). Musculoskeletal Symptoms Following COVID-19 Infection and Vaccination: An Observational Study . Jordan Medical Journal, 59(4). https://doi.org/10.35516/jmj.v59i4.2470

Issue

Section

Articles