Severe COVID-19 is associated with post-infectious inflammatory myopathy

by Anne Schänzer


Association Between SARS-CoV-2 Infection and Immune-Mediated Myopathy in Patients Who Have Died.
Aschman T, Schneider J, Greuel S, Meinhardt J, Streit S, Goebel HH, Büttnerova I, Elezkurtaj S, Scheibe F, Radke J, Meisel C, Drosten C, Radbruch H, Heppner FL, Corman VM, Stenzel W.
JAMA Neurol. 2021 Aug 1;78(8):948-960. doi: 10.1001/jamaneurol.2021.2004. PMID: 34115106


It is an ongoing debate whether skeletal muscles of patients with COVID-19 are directly involved through infection by SARS-CoV2, or whether other epiphenomena of the infection are at cause. The research group by Werner Stenzel from the Charité in Berlin has examined muscle biopsies from 43 patients who died from COVID19 disease from March 2020-February 2021. The muscle biopsies were classified based on histological and immunohistochemically stains. Most patients with severe COVID19 showed signs of myositis ranging from mild to severe. Inflammation correlated with disease duration and was comparatively more pronounced in skeletal than in cardiac tissue. In both, skeletal and cardiac samples viral load was low or absent, presumably caused by circulating viral RNA rather than direct infection by the virus. No virus particles were detected by immunohistochemistry and electron microscopy. Thus, the COVID19-associated CK elevations are most likely a post-infectious, immune-mediated myopathy. This study makes an important contribution to the understanding of muscular involvement in patients with COVID19 disease has been shed some light in this field.

muscle biopsy

About the Author

Tom Alex David Aschmann

After studying medicine in Paris, Vienna and Strasbourg (2007-2013), Tom worked in the lab and clinic in Rheumatology in Freiburg (2013-2016). Following a sabbatical with studies in Philosophy of Science in Vienna (2016-2017), he moved to Berlin and started a training in clinical Neurology first, before arriving at the Department of Neuropathology in 2020.

Published on 1 October 2021.


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This article is presented by the Publication Highlights Committee.

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