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Review
. 2022 Jan 10;23(2):720.
doi: 10.3390/ijms23020720.

COVID-19 in Joint Ageing and Osteoarthritis: Current Status and Perspectives

Marianne Lauwers  1 , Manting Au  1 , Shuofeng Yuan  2 , Chunyi Wen  1
Affiliations
Review

COVID-19 in Joint Ageing and Osteoarthritis: Current Status and Perspectives

Marianne Lauwers et al. Int J Mol Sci. .

Abstract

COVID-19 is a trending topic worldwide due to its immense impact on society. Recent trends have shifted from acute effects towards the long-term morbidity of COVID-19. In this review, we hypothesize that SARS-CoV-2 contributes to age-related perturbations in endothelial and adipose tissue, which are known to characterize the early aging process. This would explain the long-lasting symptoms of SARS-CoV-2 as the result of an accelerated aging process. Connective tissues such as adipose tissue and musculoskeletal tissue are the primary sites of aging. Therefore, current literature was analyzed focusing on the musculoskeletal symptoms in COVID-19 patients. Hypovitaminosis D, increased fragility, and calcium deficiency point towards bone aging, while joint and muscle pain are typical for joint and muscle aging, respectively. These characteristics could be classified as early osteoarthritis-like phenotype. Exploration of the impact of SARS-CoV-2 and osteoarthritis on endothelial and adipose tissue, as well as neuronal function, showed similar perturbations. At a molecular level, this could be attributed to the angiotensin-converting enzyme 2 expression, renin-angiotensin system dysfunction, and inflammation. Finally, the influence of the nicotinic cholinergic system is being evaluated as a new treatment strategy. This is combined with the current knowledge of musculoskeletal aging to pave the road towards the treatment of long-term COVID-19.

Keywords: long-COVID; musculoskeletal aging; osteoarthritis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Overview of the musculoskeletal characteristics of long-COVID.
Figure 2
Figure 2
An overview of the early aging alterations in adipose and endothelial tissue due to SARS-CoV-2 infection or ageing.
Figure 3
Figure 3
Overview of the development of acute and chronic pain after a SARS-CoV-2 infection.
Figure 4
Figure 4
(A) The renin-angiotensin system (RAS) and its involvement in SARS-CoV-2 entry into the cells. In the red boxes, the possible treatments of a SARS-CoV-2 infection involving the RAS can be found. (B) The immune system and its involvement in a SARS-CoV-2 infection. In the red boxes, the possible treatments of a SARS-CoV-2 infection involving the immune system can be found.
Figure 5
Figure 5
The role of the nicotinic cholinergic system in a SARS-CoV-2 infection.
See this image and copyright information in PMC

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