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Association between SARS-CoV-2 infection and immune-mediated myopathy in patients who have died

JAMA Jun 16, 2021

Aschman T, Schneider J, Greuel S, et al. - Since myalgia, increased levels of creatine kinase, and persistent muscle weakness have been described in patients with COVID-19, researchers performed this case-control autopsy series to explore skeletal muscle and myocardial inflammation in patients with COVID-19 who had died. This investigation was carried out in a university hospital as a multidisciplinary postmortem investigation. Patients with COVID-19 or other serious illnesses who died between March 2020 and February 2021 and were subjected to an autopsy were included in the study. The sample consisted of 43 patients with COVID-19 (median [interquartile range] age, 72 [16] years; 31 men [72%]) and 11 patients with diseases other than COVID-19 (median [interquartile range] age, 71 [5] years; 7 men [64%]). The majority of patients with severe COVID-19 showed indications of myositis ranging from mild to severe in this case-control study of patients who died with and without COVID-19. Skeletal muscle inflammation was more prominent than cardiac inflammation and was linked to the duration of illness. Most skeletal and cardiac muscles had minimal or negative viral load detection, which was most likely due to circulating viral RNA rather than genuine myocyte infection. This suggests that SARS-CoV-2 is linked to a postinfectious, immune-mediated myopathy.

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