A Northwestern Medicine study has for the first time confirmed and illustrated through radiological imaging the causes of severe, long-lasting and even bizarre symptoms among some COVID-19 patients, including rheumatoid arthritis flares, autoimmune myositis or "COVID toes."
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The study is a retrospective review of data from patients who presented to Northwestern Memorial Hospital between May 2020 and December 2020.
"We might see edema and inflammatory changes of the tissues (fluid, swelling), hematomas (collections of blood) or devitalized tissue (gangrene)," said corresponding author Swati Deshmukh, an assistant professor of musculoskeletal radiology at Northwestern University (NU) Feinberg School of Medicine and a Northwestern Medicine musculoskeletal radiologist. "In some patients, the nerves are injured (bright, enlarged) and in others, the problem is impaired blood flow (clots)."
Imaging -- CT, MRI, ultrasound -- can help explain why someone might have prolonged musculoskeletal symptoms after COVID-19.
"We've realized that the COVID virus can trigger the body to attack itself in different ways, which may lead to rheumatological issues that require lifelong management," said Deshmukh.
"Many patients with COVID-related musculoskeletal disorders recover, but for some individuals, their symptoms become serious, are deeply concerning to the patient or impact their quality of life, which leads them to seek medical attention and imaging," added Deshmukh. "That imaging allows us to see if COVID-related muscle and joint pain, for example, are not just body aches similar to what we see from the flu -- but something more insidious."
"I think it's important to differentiate between what the virus causes directly and what it triggers the body to do," Deshmukh said. "It's important for doctors to know what's happening in order to treat correctly."
The study was published Wednesday in the journal Skeletal Radiology.
Northwestern Medicine is the collaboration between Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine, which includes research, teaching and patient care. ■