SYSTEMATIC REVIEW article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1662953
This article is part of the Research TopicLong-Term Clinical and Epidemiological Perspectives on Post-Acute Sequelae of SARS-CoV-2 Infection (PASC)View all 8 articles
Musculoskeletal Manifestations in Post-Acute Sequelae of SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis
Provisionally accepted
Muhammed Shabil1
Huma Sulthana1Aftab Ullah2
Amogh Verma3Ranjana Sah4Rachana Mehta5
Dr. Asif Jan2Abdul Raheem6
Ursula Abu Nahla7*- 1MS Ramaiah University of Applied Sciences, Bengaluru, India
- 2University of Peshawar, Peshawar, Pakistan
- 3Rama Medical College Hospital and Research Centre Hapur, Hapur, India
- 4Dr D Y Patil Medical College Hospital and Research Centre, Pune, India
- 5Manav Rachna International Institute of Research and Studies, Faridabad, India
- 6CECOS University, Peshawar, Pakistan
- 7Hebron University Faculty of Science and Technology, Hebron, Palestine
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Background: The COVID-19 pandemic has highlighted a spectrum of long-term sequelae, with musculoskeletal symptoms being a substantial component of Post-Acute Sequelae of SARS-CoV-2 infection (PASC). This systematic review and meta-analysis aimed to evaluate the incidence and nature of musculoskeletal manifestations in individuals recovering from COVID-19. Methods: A systematic search across PubMed, Embase, and Web of Science was performed up to February 15, 2024, to identify studies reporting on musculoskeletal symptoms post-COVID-19. Observational studies which reported any musculoskeletal symptoms of PASC were included. Data were pooled using a random-effects model to calculate the incidence of symptoms, with subgroup analyses based on time since infection. Statistical analysis were conducted in R software (V 4.3). Results: Sixty-four studies were included, demonstrating a pooled prevalence of muscle pain at 28% (95% CI: 22% to 35%), which increased to 25.9% (95% CI: 20.7% to 31.7%) at 12 months post-infection. Joint pain showed a pooled prevalence of 14.8% (95% CI: 10.6% to 20.2%), with no significant temporal change. Muscle weakness was observed in 12.9% (95% CI: 4.2% to 32.9%) of patients. Notable heterogeneity was observed across studies (I² > 89% for all symptoms). Conclusion: Musculoskeletal symptoms are prevalent in individuals with PASC, with muscle pain being the most common. The findings highlight the need for comprehensive clinical management and continuous research to create targeted treatments and revise care protocols as the pandemic evolves.
Keywords: post-acute sequelae of SARS-CoV-2 infection, Muscle pain, joint pain, Muscle Weakness, Long Covid, Good health and well-being
Received: 09 Jul 2025; Accepted: 29 Aug 2025.
Copyright: © 2025 Shabil, Sulthana, Ullah, Verma, Sah, Mehta, Asif Jan, Raheem and Abu Nahla. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ursula Abu Nahla, Hebron University Faculty of Science and Technology, Hebron, Palestine
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