Frozen Shoulder in Patients with COVID-19

Abstract

Introduction: Because COVID-19 with extrapulmonary manifestations is likely to lead to the development of musculoskeletal disorders in susceptible individuals due to immunological mechanisms, it is possible to see more frozen shoulder cases during the COVID-19 pandemic. Therefore, this study was performed to evaluate the relationship of frozen shoulder and COVID-19. Materials and Methods: This study was a cross-sectional study from September 2020 to February 2021; patients who were referred to our shoulder clinic with stiffness and shoulder pain and diagnosed with adhesive capsulitis (AC) were evaluated for COVID-19 involvement. Shoulder range of motion was assessed as passive range of motion of forwarding flexion, internal rotation and external rotation in the arm at the side and 90° abduction. The visual analogue scale was also used to assess pain intensity. SPSS software was used for analysis, and Chi-square test was used for qualitative data analysis and a t-test was used for quantitative data. Results: Seventy-two patients with frozen shoulders were included in the study; the results showed that AC occurs at a younger age in patients with COVID-19 infection (P < 0.039); the mean age of all patients was 52.73 ± 8.68. The severity of pain was higher in patients with COVID-19 (P = 0.012). Furthermore, regarding the duration of referral in terms of months, it was shown that people with COVID-19 were referred in a shorter period after the onset of shoulder symptoms and there was a significant difference in terms of referral time and pain between the two groups (P < 0.01). Regular activity had a lower rate in patients with COVID-19 infection and the difference was significant in patients with and without COVID-19 (P < 0.029). Conclusion: Due to younger age, greater pain and faster visit of patients with a frozen shoulder after COVID-19, it is recommended to look for frozen shoulder in all COVID-19-infected patients by a complete clinical examination. This is more important in patients without regular physical activity.