Association of COVID-19 Infection with Musculoskeletal Function and Physical Performance among Adult Patients

Abstract

Background: Coronavirus disease 2019 (COVID-19) is associated with a wide range of long-term health consequences, including musculoskeletal symptoms and impaired physical performance. Persistent muscle weakness, fatigue, and reduced functional capacity may adversely affect recovery and quality of life among affected individuals. This study aimed to assess the association of COVID-19 infection with musculoskeletal function and physical performance among adult patients. Methods: This hospital-based cross-sectional analytical study was conducted in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2021 to June 2022. A total of 155 adults with a history of confirmed COVID-19 infection were enrolled using purposive sampling. Data were collected through a structured questionnaire and clinical assessments. Muscle strength was evaluated using a handgrip dynamometer, physical performance by the Six-Minute Walk Test (6MWT), and fatigue by the Fatigue Severity Scale (FSS). Associations between COVID-19 severity and musculoskeletal outcomes were analyzed using the Chi-square test. Results: Among the participants, 39.4% had mild, 37.4% moderate, and 23.2% severe COVID-19 infection. Overall, 72.3% reported at least one musculoskeletal symptom after infection. Muscle weakness (61.9%), joint pain (54.8%), and back pain (47.1%) were the most common complaints. Mean handgrip strength was 28.4±6.2 kg in males and 19.6±4.8 kg in females. The mean 6MWT distance was 412±68 meters, while the mean FSS score was 4.3±1.2. Reduced muscle strength, reduced walking capacity, and moderate-to-severe fatigue were observed in 63.2%, 58.1%, and 70.3% of participants, respectively. The prevalence of muscle weakness, reduced physical performance, and severe fatigue increased significantly with increasing COVID-19 severity (p<0.001). Conclusion: COVID-19 infection is associated with significant musculoskeletal impairment, reduced physical performance, and fatigue, particularly among patients with severe disease. Early rehabilitation interventions may improve functional recovery and long-term outcomes.

Journal of Paediatric Surgeons of Bangladesh (2026) Vol. 17 (1): 95-99