Page 16 - CASA Bulletin of Anesthiology 2021, Vol 8, No. 6 (1)

CASA Bulletin of Anesthesiology

spleen, gastrointestinal system, bladder, cornea, and blood vessels. The ACE2 receptor is also
8, 9
found in the central and peripheral nervous systems and in skeletal muscle. , Viral replication
10 11
within human host cells is followed by viral release through cell destruction. In addition, SARS-
CoV-2 activates an inflammatory response (both innate and adaptive immune responses) which
can result in a cytokine storm and ultimately multi-organ injury.
8, 9

Fig. 1 Multi-organ injury and musculoskeletal involvement in COVID-19
7
The SARS-CoV-2 virus not only invades the respiratory system and causes fever, cough,
sore throat, and other pneumonia associated symptoms, but also infects other systems in humans
and results in corresponding symptoms, including the nervous system (headache, dizziness, and
confusion), digestive system (diarrhea, abdominal pain, and loss of appetite), and cardiovascular
system (chest pain, and cardiac injury). 5, 12

Imaging

There have been emerging reports; however, of an array of neuromuscular and rheumatologic
complications related to COVID-19 infection and disease course including myositis, neuropathy,
arthropathy, and soft tissue abnormalities. Multimodality supports diagnosis and evaluation of
musculoskeletal disorders in COVID-19 patients, Table 1. 7

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