4.7 Review

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

Journal

Publisher

MDPI
DOI: 10.3390/ijms23020720

Keywords

long-COVID; osteoarthritis; musculoskeletal aging

Funding

  1. Health and Medical Research Fund Scheme [01150087, 16172691]
  2. Research Grants Council of Hong Kong ECS [PolyU 251008/18M]
  3. GRF [PolyU 151061/20M, PolyU15100821M]
  4. NFSC/RGC schemes [N_PolyU 520/20]
  5. ITF MHKJFS [MHP/011/20]
  6. Hong Kong Polytechnic University Project of Strategic Importance (ZE2C)
  7. [151061/20M]

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This review examines the impact of SARS-CoV-2 on endothelial and adipose tissue, as well as its effect on musculoskeletal aging. It suggests that the long-lasting symptoms of COVID-19 may be due to an accelerated aging process. Analysis of musculoskeletal symptoms in COVID-19 patients reveals characteristics associated with bone and joint aging. The study highlights the similarities between SARS-CoV-2 and osteoarthritis in their effects on tissues and neuronal function.
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.

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