PMC:7212949 / 61608-64058 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7212949","sourcedb":"PMC","sourceid":"7212949","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7212949","text":"MUSCULOCUTANEOUS MANIFESTATIONS\n\nSARS-CoV\nAs many as 60% of patients with SARS-CoV had myalgia with up to 30% presenting with muscle weakness and increased creatinine phosphokinase (Table 6).10 , 34 , 117, 118, 119 However, there was no statistically significant difference in creatinine phosphokinase levels between SARS-CoV patients with ARDS vs. patients without ARDS.117 Muscle weakness was typically symmetric and involves truncal and weakness of the proximal limbs and neck muscles with sparing of the facial and small hand muscles.119 Muscle atrophy may also be the result of steroid myopathy or critical illness myopathy 119 A variable degree of focal myofibril necrosis noted postmortem without evidence of viral particles suggests that muscle damage is likely the result of immune-mediated damage.119 Cutaneous manifestations of SARS-CoV hasn't yet been reported in the literature to the authors’ knowledge.\n\nMERS-CoV\nMyositis and muscle atrophy are less prevalent than SARS-CoV.61 , 120 Muscle weakness was common in patients with MERS-CoV (Table 6).114 Pathologic specimens mimic SARS-CoV specimens with myopathy and inflammatory cells in the areas of myofibril atrophy.61 Similar to SARS-CoV, cutaneous manifestation of MERS-CoV infection is rare and has not been widely reported.\n\nCOVID-19\nMyalgia is also a common presenting symptom of COVID-19 infection, and 36% of patients develop muscle pain during their illness (Table 6).121 High creatinine kinase (CK) levels present in 14% to 33% of patients.22 , 41 , 106 , 122 Patients with suspected COVID-19 and muscle aches were more likely to have abnormal lung imaging findings.122 Higher CK levels noted in ICU-level patients in a study compared to non-ICU patients, although it was not a statistically significant finding. Rhabdomyolosis has been reported in patients with COVID-19 with MYO levels \u003e12,000 ug/L and CK levels \u003e11,000 U/L.123\nThe cutaneous manifestations of COVID-19 are not widely known beyond the dermatology community. From a series of 88 patients 20% developed cutaneous manifestations including erythematous rash, widespread urticaria, and chickenpox like vesicles.124 The most common region involved was the trunk and pruritis was uncommon. Several recent case series have reported a viral exanthum similar to chilblains disease in patients with COVID-19.125 To date, there has been no correlation between cutaneous manifestations of COVID-19 and disease 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