PMC:7309518 / 16371-17803 JSONTXT

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    LitCovid-PD-FMA-UBERON

    {"project":"LitCovid-PD-FMA-UBERON","denotations":[{"id":"T105","span":{"begin":103,"end":109},"obj":"Body_part"},{"id":"T106","span":{"begin":337,"end":340},"obj":"Body_part"},{"id":"T107","span":{"begin":541,"end":547},"obj":"Body_part"},{"id":"T108","span":{"begin":691,"end":697},"obj":"Body_part"},{"id":"T109","span":{"begin":709,"end":717},"obj":"Body_part"},{"id":"T110","span":{"begin":1025,"end":1031},"obj":"Body_part"},{"id":"T111","span":{"begin":1126,"end":1139},"obj":"Body_part"},{"id":"T112","span":{"begin":1281,"end":1285},"obj":"Body_part"},{"id":"T113","span":{"begin":1328,"end":1333},"obj":"Body_part"},{"id":"T114","span":{"begin":1337,"end":1347},"obj":"Body_part"},{"id":"T115","span":{"begin":1358,"end":1370},"obj":"Body_part"},{"id":"T116","span":{"begin":1414,"end":1423},"obj":"Body_part"}],"attributes":[{"id":"A105","pred":"fma_id","subj":"T105","obj":"http://purl.org/sig/ont/fma/fma32558"},{"id":"A106","pred":"fma_id","subj":"T106","obj":"http://purl.org/sig/ont/fma/fma278683"},{"id":"A107","pred":"fma_id","subj":"T107","obj":"http://purl.org/sig/ont/fma/fma32558"},{"id":"A108","pred":"fma_id","subj":"T108","obj":"http://purl.org/sig/ont/fma/fma32558"},{"id":"A109","pred":"fma_id","subj":"T109","obj":"http://purl.org/sig/ont/fma/fma62871"},{"id":"A110","pred":"fma_id","subj":"T110","obj":"http://purl.org/sig/ont/fma/fma32558"},{"id":"A111","pred":"fma_id","subj":"T111","obj":"http://purl.org/sig/ont/fma/fma67328"},{"id":"A112","pred":"fma_id","subj":"T112","obj":"http://purl.org/sig/ont/fma/fma68646"},{"id":"A113","pred":"fma_id","subj":"T113","obj":"http://purl.org/sig/ont/fma/fma68646"},{"id":"A114","pred":"fma_id","subj":"T114","obj":"http://purl.org/sig/ont/fma/fma63261"},{"id":"A115","pred":"fma_id","subj":"T115","obj":"http://purl.org/sig/ont/fma/fma67328"},{"id":"A116","pred":"fma_id","subj":"T116","obj":"http://purl.org/sig/ont/fma/fma84050"}],"text":"Myopathic symptoms in a severe systemic viral disease are multifactorial, but an acute onset of severe muscle weakness with increased inflammatory markers and very high CK levels in the thousands, as described above, is consistent with autoimmune inflammatory myopathy within the spectrum of NAM, similar to what was first reported with HIV early in that epidemic.22,23 The most common causes of NAM are not chronic statin use as overstated, but autoimmune, paraneoplastic, or postviral.22–25 Considering that very high CK level and painful muscle weakness were seen in 10% of COVID-19–positive patients,6 a potentially treatable autoimmune myopathy has been likely overlooked. Studies with muscle biopsy and antibody screening are urgently needed in such patients because therapy with IVIg can improve strength, reduce morbidity, and facilitate recovery, as reported in the first 2 cases.20,21 COVID-19–associated myositis is also highly interesting because ACE-2, the SARS-CoV receptor, is reportedly expressed in skeletal muscle.26 If this is confirmed, COVID-19 may represent the first virus directly capable of infecting muscle fibers. None of the viruses implicated in viral-triggered myositis has so far been shown to infect muscle27,28; instead, viruses induce an immune T cell with clonal expansion of viral-specific T cells or macrophage-mediated, muscle fiber autoinvasion with abundant proinflammatory cytokines.22,29,30"}

    LitCovid-PD-MONDO

    {"project":"LitCovid-PD-MONDO","denotations":[{"id":"T243","span":{"begin":40,"end":53},"obj":"Disease"},{"id":"T244","span":{"begin":169,"end":171},"obj":"Disease"},{"id":"T245","span":{"begin":247,"end":268},"obj":"Disease"},{"id":"T246","span":{"begin":260,"end":268},"obj":"Disease"},{"id":"T247","span":{"begin":292,"end":295},"obj":"Disease"},{"id":"T249","span":{"begin":396,"end":399},"obj":"Disease"},{"id":"T251","span":{"begin":520,"end":522},"obj":"Disease"},{"id":"T252","span":{"begin":577,"end":585},"obj":"Disease"},{"id":"T253","span":{"begin":641,"end":649},"obj":"Disease"},{"id":"T254","span":{"begin":895,"end":903},"obj":"Disease"},{"id":"T255","span":{"begin":915,"end":923},"obj":"Disease"},{"id":"T257","span":{"begin":970,"end":978},"obj":"Disease"},{"id":"T258","span":{"begin":1057,"end":1065},"obj":"Disease"},{"id":"T259","span":{"begin":1191,"end":1199},"obj":"Disease"}],"attributes":[{"id":"A243","pred":"mondo_id","subj":"T243","obj":"http://purl.obolibrary.org/obo/MONDO_0005108"},{"id":"A244","pred":"mondo_id","subj":"T244","obj":"http://purl.obolibrary.org/obo/MONDO_0017941"},{"id":"A245","pred":"mondo_id","subj":"T245","obj":"http://purl.obolibrary.org/obo/MONDO_0007827"},{"id":"A246","pred":"mondo_id","subj":"T246","obj":"http://purl.obolibrary.org/obo/MONDO_0005336"},{"id":"A247","pred":"mondo_id","subj":"T247","obj":"http://purl.obolibrary.org/obo/MONDO_0009722"},{"id":"A248","pred":"mondo_id","subj":"T247","obj":"http://purl.obolibrary.org/obo/MONDO_0016098"},{"id":"A249","pred":"mondo_id","subj":"T249","obj":"http://purl.obolibrary.org/obo/MONDO_0009722"},{"id":"A250","pred":"mondo_id","subj":"T249","obj":"http://purl.obolibrary.org/obo/MONDO_0016098"},{"id":"A251","pred":"mondo_id","subj":"T251","obj":"http://purl.obolibrary.org/obo/MONDO_0017941"},{"id":"A252","pred":"mondo_id","subj":"T252","obj":"http://purl.obolibrary.org/obo/MONDO_0100096"},{"id":"A253","pred":"mondo_id","subj":"T253","obj":"http://purl.obolibrary.org/obo/MONDO_0005336"},{"id":"A254","pred":"mondo_id","subj":"T254","obj":"http://purl.obolibrary.org/obo/MONDO_0100096"},{"id":"A255","pred":"mondo_id","subj":"T255","obj":"http://purl.obolibrary.org/obo/MONDO_0008054"},{"id":"A256","pred":"mondo_id","subj":"T255","obj":"http://purl.obolibrary.org/obo/MONDO_0021167"},{"id":"A257","pred":"mondo_id","subj":"T257","obj":"http://purl.obolibrary.org/obo/MONDO_0005091"},{"id":"A258","pred":"mondo_id","subj":"T258","obj":"http://purl.obolibrary.org/obo/MONDO_0100096"},{"id":"A259","pred":"mondo_id","subj":"T259","obj":"http://purl.obolibrary.org/obo/MONDO_0008054"},{"id":"A260","pred":"mondo_id","subj":"T259","obj":"http://purl.obolibrary.org/obo/MONDO_0021167"}],"text":"Myopathic symptoms in a severe systemic viral disease are multifactorial, but an acute onset of severe muscle weakness with increased inflammatory markers and very high CK levels in the thousands, as described above, is consistent with autoimmune inflammatory myopathy within the spectrum of NAM, similar to what was first reported with HIV early in that epidemic.22,23 The most common causes of NAM are not chronic statin use as overstated, but autoimmune, paraneoplastic, or postviral.22–25 Considering that very high CK level and painful muscle weakness were seen in 10% of COVID-19–positive patients,6 a potentially treatable autoimmune myopathy has been likely overlooked. Studies with muscle biopsy and antibody screening are urgently needed in such patients because therapy with IVIg can improve strength, reduce morbidity, and facilitate recovery, as reported in the first 2 cases.20,21 COVID-19–associated myositis is also highly interesting because ACE-2, the SARS-CoV receptor, is reportedly expressed in skeletal muscle.26 If this is confirmed, COVID-19 may represent the first virus directly capable of infecting muscle fibers. None of the viruses implicated in viral-triggered myositis has so far been shown to infect muscle27,28; instead, viruses induce an immune T cell with clonal expansion of viral-specific T cells or macrophage-mediated, muscle fiber autoinvasion with abundant proinflammatory cytokines.22,29,30"}

    LitCovid-PD-CLO

    {"project":"LitCovid-PD-CLO","denotations":[{"id":"T122","span":{"begin":22,"end":23},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T123","span":{"begin":103,"end":109},"obj":"http://purl.obolibrary.org/obo/UBERON_0001630"},{"id":"T124","span":{"begin":103,"end":109},"obj":"http://purl.obolibrary.org/obo/UBERON_0005090"},{"id":"T125","span":{"begin":103,"end":109},"obj":"http://www.ebi.ac.uk/efo/EFO_0000801"},{"id":"T126","span":{"begin":103,"end":109},"obj":"http://www.ebi.ac.uk/efo/EFO_0001949"},{"id":"T127","span":{"begin":487,"end":489},"obj":"http://purl.obolibrary.org/obo/CLO_0050507"},{"id":"T128","span":{"begin":541,"end":547},"obj":"http://purl.obolibrary.org/obo/UBERON_0001630"},{"id":"T129","span":{"begin":541,"end":547},"obj":"http://purl.obolibrary.org/obo/UBERON_0005090"},{"id":"T130","span":{"begin":541,"end":547},"obj":"http://www.ebi.ac.uk/efo/EFO_0000801"},{"id":"T131","span":{"begin":541,"end":547},"obj":"http://www.ebi.ac.uk/efo/EFO_0001949"},{"id":"T132","span":{"begin":606,"end":607},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T133","span":{"begin":650,"end":653},"obj":"http://purl.obolibrary.org/obo/CLO_0051582"},{"id":"T134","span":{"begin":691,"end":697},"obj":"http://purl.obolibrary.org/obo/UBERON_0001630"},{"id":"T135","span":{"begin":691,"end":697},"obj":"http://purl.obolibrary.org/obo/UBERON_0005090"},{"id":"T136","span":{"begin":691,"end":697},"obj":"http://www.ebi.ac.uk/efo/EFO_0000801"},{"id":"T137","span":{"begin":691,"end":697},"obj":"http://www.ebi.ac.uk/efo/EFO_0001949"},{"id":"T138","span":{"begin":1016,"end":1031},"obj":"http://purl.obolibrary.org/obo/UBERON_0001134"},{"id":"T139","span":{"begin":1016,"end":1031},"obj":"http://purl.obolibrary.org/obo/UBERON_0014892"},{"id":"T140","span":{"begin":1016,"end":1031},"obj":"http://www.ebi.ac.uk/efo/EFO_0000888"},{"id":"T141","span":{"begin":1090,"end":1095},"obj":"http://purl.obolibrary.org/obo/NCBITaxon_10239"},{"id":"T142","span":{"begin":1126,"end":1132},"obj":"http://purl.obolibrary.org/obo/UBERON_0001630"},{"id":"T143","span":{"begin":1126,"end":1132},"obj":"http://purl.obolibrary.org/obo/UBERON_0005090"},{"id":"T144","span":{"begin":1126,"end":1132},"obj":"http://www.ebi.ac.uk/efo/EFO_0000801"},{"id":"T145","span":{"begin":1126,"end":1132},"obj":"http://www.ebi.ac.uk/efo/EFO_0001949"},{"id":"T146","span":{"begin":1153,"end":1160},"obj":"http://purl.obolibrary.org/obo/NCBITaxon_10239"},{"id":"T147","span":{"begin":1200,"end":1203},"obj":"http://purl.obolibrary.org/obo/CLO_0051582"},{"id":"T148","span":{"begin":1254,"end":1261},"obj":"http://purl.obolibrary.org/obo/NCBITaxon_10239"},{"id":"T149","span":{"begin":1279,"end":1285},"obj":"http://purl.obolibrary.org/obo/CL_0000084"},{"id":"T150","span":{"begin":1326,"end":1333},"obj":"http://purl.obolibrary.org/obo/CL_0000084"},{"id":"T151","span":{"begin":1358,"end":1364},"obj":"http://purl.obolibrary.org/obo/UBERON_0001630"},{"id":"T152","span":{"begin":1358,"end":1364},"obj":"http://purl.obolibrary.org/obo/UBERON_0005090"},{"id":"T153","span":{"begin":1358,"end":1364},"obj":"http://www.ebi.ac.uk/efo/EFO_0000801"},{"id":"T154","span":{"begin":1358,"end":1364},"obj":"http://www.ebi.ac.uk/efo/EFO_0001949"}],"text":"Myopathic symptoms in a severe systemic viral disease are multifactorial, but an acute onset of severe muscle weakness with increased inflammatory markers and very high CK levels in the thousands, as described above, is consistent with autoimmune inflammatory myopathy within the spectrum of NAM, similar to what was first reported with HIV early in that epidemic.22,23 The most common causes of NAM are not chronic statin use as overstated, but autoimmune, paraneoplastic, or postviral.22–25 Considering that very high CK level and painful muscle weakness were seen in 10% of COVID-19–positive patients,6 a potentially treatable autoimmune myopathy has been likely overlooked. Studies with muscle biopsy and antibody screening are urgently needed in such patients because therapy with IVIg can improve strength, reduce morbidity, and facilitate recovery, as reported in the first 2 cases.20,21 COVID-19–associated myositis is also highly interesting because ACE-2, the SARS-CoV receptor, is reportedly expressed in skeletal muscle.26 If this is confirmed, COVID-19 may represent the first virus directly capable of infecting muscle fibers. None of the viruses implicated in viral-triggered myositis has so far been shown to infect muscle27,28; instead, viruses induce an immune T cell with clonal expansion of viral-specific T cells or macrophage-mediated, muscle fiber autoinvasion with abundant proinflammatory cytokines.22,29,30"}

    LitCovid-PD-CHEBI

    {"project":"LitCovid-PD-CHEBI","denotations":[{"id":"T93","span":{"begin":416,"end":422},"obj":"Chemical"}],"attributes":[{"id":"A93","pred":"chebi_id","subj":"T93","obj":"http://purl.obolibrary.org/obo/CHEBI_87631"}],"text":"Myopathic symptoms in a severe systemic viral disease are multifactorial, but an acute onset of severe muscle weakness with increased inflammatory markers and very high CK levels in the thousands, as described above, is consistent with autoimmune inflammatory myopathy within the spectrum of NAM, similar to what was first reported with HIV early in that epidemic.22,23 The most common causes of NAM are not chronic statin use as overstated, but autoimmune, paraneoplastic, or postviral.22–25 Considering that very high CK level and painful muscle weakness were seen in 10% of COVID-19–positive patients,6 a potentially treatable autoimmune myopathy has been likely overlooked. Studies with muscle biopsy and antibody screening are urgently needed in such patients because therapy with IVIg can improve strength, reduce morbidity, and facilitate recovery, as reported in the first 2 cases.20,21 COVID-19–associated myositis is also highly interesting because ACE-2, the SARS-CoV receptor, is reportedly expressed in skeletal muscle.26 If this is confirmed, COVID-19 may represent the first virus directly capable of infecting muscle fibers. None of the viruses implicated in viral-triggered myositis has so far been shown to infect muscle27,28; instead, viruses induce an immune T cell with clonal expansion of viral-specific T cells or macrophage-mediated, muscle fiber autoinvasion with abundant proinflammatory cytokines.22,29,30"}

    LitCovid-PubTator

    {"project":"LitCovid-PubTator","denotations":[{"id":"627","span":{"begin":959,"end":964},"obj":"Gene"},{"id":"628","span":{"begin":169,"end":171},"obj":"Gene"},{"id":"629","span":{"begin":520,"end":522},"obj":"Gene"},{"id":"630","span":{"begin":595,"end":603},"obj":"Species"},{"id":"631","span":{"begin":756,"end":764},"obj":"Species"},{"id":"632","span":{"begin":970,"end":978},"obj":"Species"},{"id":"633","span":{"begin":0,"end":18},"obj":"Disease"},{"id":"634","span":{"begin":40,"end":53},"obj":"Disease"},{"id":"635","span":{"begin":103,"end":118},"obj":"Disease"},{"id":"636","span":{"begin":260,"end":268},"obj":"Disease"},{"id":"637","span":{"begin":337,"end":340},"obj":"Disease"},{"id":"638","span":{"begin":458,"end":472},"obj":"Disease"},{"id":"639","span":{"begin":533,"end":556},"obj":"Disease"},{"id":"640","span":{"begin":577,"end":585},"obj":"Disease"},{"id":"641","span":{"begin":630,"end":649},"obj":"Disease"},{"id":"642","span":{"begin":895,"end":903},"obj":"Disease"},{"id":"643","span":{"begin":915,"end":923},"obj":"Disease"},{"id":"644","span":{"begin":1057,"end":1065},"obj":"Disease"},{"id":"645","span":{"begin":1191,"end":1199},"obj":"Disease"}],"attributes":[{"id":"A627","pred":"tao:has_database_id","subj":"627","obj":"Gene:59272"},{"id":"A628","pred":"tao:has_database_id","subj":"628","obj":"Gene:51727"},{"id":"A629","pred":"tao:has_database_id","subj":"629","obj":"Gene:51727"},{"id":"A630","pred":"tao:has_database_id","subj":"630","obj":"Tax:9606"},{"id":"A631","pred":"tao:has_database_id","subj":"631","obj":"Tax:9606"},{"id":"A632","pred":"tao:has_database_id","subj":"632","obj":"Tax:694009"},{"id":"A633","pred":"tao:has_database_id","subj":"633","obj":"MESH:D051271"},{"id":"A634","pred":"tao:has_database_id","subj":"634","obj":"MESH:D001102"},{"id":"A635","pred":"tao:has_database_id","subj":"635","obj":"MESH:D018908"},{"id":"A636","pred":"tao:has_database_id","subj":"636","obj":"MESH:D009135"},{"id":"A637","pred":"tao:has_database_id","subj":"637","obj":"MESH:D015658"},{"id":"A638","pred":"tao:has_database_id","subj":"638","obj":"MESH:D010257"},{"id":"A639","pred":"tao:has_database_id","subj":"639","obj":"MESH:D018908"},{"id":"A640","pred":"tao:has_database_id","subj":"640","obj":"MESH:C000657245"},{"id":"A641","pred":"tao:has_database_id","subj":"641","obj":"MESH:D009135"},{"id":"A642","pred":"tao:has_database_id","subj":"642","obj":"MESH:C000657245"},{"id":"A643","pred":"tao:has_database_id","subj":"643","obj":"MESH:D009220"},{"id":"A644","pred":"tao:has_database_id","subj":"644","obj":"MESH:C000657245"},{"id":"A645","pred":"tao:has_database_id","subj":"645","obj":"MESH:D009220"}],"namespaces":[{"prefix":"Tax","uri":"https://www.ncbi.nlm.nih.gov/taxonomy/"},{"prefix":"MESH","uri":"https://id.nlm.nih.gov/mesh/"},{"prefix":"Gene","uri":"https://www.ncbi.nlm.nih.gov/gene/"},{"prefix":"CVCL","uri":"https://web.expasy.org/cellosaurus/CVCL_"}],"text":"Myopathic symptoms in a severe systemic viral disease are multifactorial, but an acute onset of severe muscle weakness with increased inflammatory markers and very high CK levels in the thousands, as described above, is consistent with autoimmune inflammatory myopathy within the spectrum of NAM, similar to what was first reported with HIV early in that epidemic.22,23 The most common causes of NAM are not chronic statin use as overstated, but autoimmune, paraneoplastic, or postviral.22–25 Considering that very high CK level and painful muscle weakness were seen in 10% of COVID-19–positive patients,6 a potentially treatable autoimmune myopathy has been likely overlooked. Studies with muscle biopsy and antibody screening are urgently needed in such patients because therapy with IVIg can improve strength, reduce morbidity, and facilitate recovery, as reported in the first 2 cases.20,21 COVID-19–associated myositis is also highly interesting because ACE-2, the SARS-CoV receptor, is reportedly expressed in skeletal muscle.26 If this is confirmed, COVID-19 may represent the first virus directly capable of infecting muscle fibers. None of the viruses implicated in viral-triggered myositis has so far been shown to infect muscle27,28; instead, viruses induce an immune T cell with clonal expansion of viral-specific T cells or macrophage-mediated, muscle fiber autoinvasion with abundant proinflammatory cytokines.22,29,30"}

    LitCovid-sentences

    {"project":"LitCovid-sentences","denotations":[{"id":"T63","span":{"begin":0,"end":677},"obj":"Sentence"},{"id":"T64","span":{"begin":678,"end":1140},"obj":"Sentence"},{"id":"T65","span":{"begin":1141,"end":1432},"obj":"Sentence"}],"namespaces":[{"prefix":"_base","uri":"http://pubannotation.org/ontology/tao.owl#"}],"text":"Myopathic symptoms in a severe systemic viral disease are multifactorial, but an acute onset of severe muscle weakness with increased inflammatory markers and very high CK levels in the thousands, as described above, is consistent with autoimmune inflammatory myopathy within the spectrum of NAM, similar to what was first reported with HIV early in that epidemic.22,23 The most common causes of NAM are not chronic statin use as overstated, but autoimmune, paraneoplastic, or postviral.22–25 Considering that very high CK level and painful muscle weakness were seen in 10% of COVID-19–positive patients,6 a potentially treatable autoimmune myopathy has been likely overlooked. Studies with muscle biopsy and antibody screening are urgently needed in such patients because therapy with IVIg can improve strength, reduce morbidity, and facilitate recovery, as reported in the first 2 cases.20,21 COVID-19–associated myositis is also highly interesting because ACE-2, the SARS-CoV receptor, is reportedly expressed in skeletal muscle.26 If this is confirmed, COVID-19 may represent the first virus directly capable of infecting muscle fibers. None of the viruses implicated in viral-triggered myositis has so far been shown to infect muscle27,28; instead, viruses induce an immune T cell with clonal expansion of viral-specific T cells or macrophage-mediated, muscle fiber autoinvasion with abundant proinflammatory cytokines.22,29,30"}

    LitCovid-PD-HP

    {"project":"LitCovid-PD-HP","denotations":[{"id":"T120","span":{"begin":103,"end":118},"obj":"Phenotype"},{"id":"T121","span":{"begin":247,"end":268},"obj":"Phenotype"},{"id":"T122","span":{"begin":541,"end":556},"obj":"Phenotype"},{"id":"T123","span":{"begin":641,"end":649},"obj":"Phenotype"},{"id":"T124","span":{"begin":915,"end":923},"obj":"Phenotype"},{"id":"T125","span":{"begin":1191,"end":1199},"obj":"Phenotype"}],"attributes":[{"id":"A120","pred":"hp_id","subj":"T120","obj":"http://purl.obolibrary.org/obo/HP_0001324"},{"id":"A121","pred":"hp_id","subj":"T121","obj":"http://purl.obolibrary.org/obo/HP_0009071"},{"id":"A122","pred":"hp_id","subj":"T122","obj":"http://purl.obolibrary.org/obo/HP_0001324"},{"id":"A123","pred":"hp_id","subj":"T123","obj":"http://purl.obolibrary.org/obo/HP_0003198"},{"id":"A124","pred":"hp_id","subj":"T124","obj":"http://purl.obolibrary.org/obo/HP_0100614"},{"id":"A125","pred":"hp_id","subj":"T125","obj":"http://purl.obolibrary.org/obo/HP_0100614"}],"text":"Myopathic symptoms in a severe systemic viral disease are multifactorial, but an acute onset of severe muscle weakness with increased inflammatory markers and very high CK levels in the thousands, as described above, is consistent with autoimmune inflammatory myopathy within the spectrum of NAM, similar to what was first reported with HIV early in that epidemic.22,23 The most common causes of NAM are not chronic statin use as overstated, but autoimmune, paraneoplastic, or postviral.22–25 Considering that very high CK level and painful muscle weakness were seen in 10% of COVID-19–positive patients,6 a potentially treatable autoimmune myopathy has been likely overlooked. Studies with muscle biopsy and antibody screening are urgently needed in such patients because therapy with IVIg can improve strength, reduce morbidity, and facilitate recovery, as reported in the first 2 cases.20,21 COVID-19–associated myositis is also highly interesting because ACE-2, the SARS-CoV receptor, is reportedly expressed in skeletal muscle.26 If this is confirmed, COVID-19 may represent the first virus directly capable of infecting muscle fibers. None of the viruses implicated in viral-triggered myositis has so far been shown to infect muscle27,28; instead, viruses induce an immune T cell with clonal expansion of viral-specific T cells or macrophage-mediated, muscle fiber autoinvasion with abundant proinflammatory cytokines.22,29,30"}

    2_test

    {"project":"2_test","denotations":[{"id":"32518172-25923553-75850518","span":{"begin":364,"end":366},"obj":"25923553"},{"id":"32518172-3464769-75850519","span":{"begin":367,"end":369},"obj":"3464769"},{"id":"32518172-25923553-75850520","span":{"begin":487,"end":489},"obj":"25923553"},{"id":"32518172-3464769-75850520","span":{"begin":487,"end":489},"obj":"3464769"},{"id":"32518172-27147697-75850521","span":{"begin":490,"end":492},"obj":"27147697"},{"id":"32518172-32382463-75850522","span":{"begin":889,"end":891},"obj":"32382463"},{"id":"32518172-25764065-75850523","span":{"begin":1032,"end":1034},"obj":"25764065"},{"id":"32518172-1349938-75850524","span":{"begin":1238,"end":1240},"obj":"1349938"},{"id":"32518172-8455655-75850525","span":{"begin":1241,"end":1243},"obj":"8455655"},{"id":"32518172-25923553-75850526","span":{"begin":1424,"end":1426},"obj":"25923553"},{"id":"32518172-1859178-75850527","span":{"begin":1427,"end":1429},"obj":"1859178"},{"id":"32518172-17366634-75850528","span":{"begin":1430,"end":1432},"obj":"17366634"}],"text":"Myopathic symptoms in a severe systemic viral disease are multifactorial, but an acute onset of severe muscle weakness with increased inflammatory markers and very high CK levels in the thousands, as described above, is consistent with autoimmune inflammatory myopathy within the spectrum of NAM, similar to what was first reported with HIV early in that epidemic.22,23 The most common causes of NAM are not chronic statin use as overstated, but autoimmune, paraneoplastic, or postviral.22–25 Considering that very high CK level and painful muscle weakness were seen in 10% of COVID-19–positive patients,6 a potentially treatable autoimmune myopathy has been likely overlooked. Studies with muscle biopsy and antibody screening are urgently needed in such patients because therapy with IVIg can improve strength, reduce morbidity, and facilitate recovery, as reported in the first 2 cases.20,21 COVID-19–associated myositis is also highly interesting because ACE-2, the SARS-CoV receptor, is reportedly expressed in skeletal muscle.26 If this is confirmed, COVID-19 may represent the first virus directly capable of infecting muscle fibers. None of the viruses implicated in viral-triggered myositis has so far been shown to infect muscle27,28; instead, viruses induce an immune T cell with clonal expansion of viral-specific T cells or macrophage-mediated, muscle fiber autoinvasion with abundant proinflammatory cytokines.22,29,30"}