Background the main and most severe manifestation of the SARS-CoV2 infection is pneumonia, but other organ-specific symptoms have been described (myocarditis, encephalitis,..), and some sparse cases have reported musculoskeletal (MSK) symptoms following such an infection.

Objectives to determine the prevalence of MSK symptoms appearing after a SARS-CoV2 infection.

Methods this was an observational cohort based on data available at the Assistance Publique-Hôpitaux de Paris (APHP) Clinical Data Warehouse (which includes data from patients admitted in the 39 APHP hospitals). Data collected included both ICD-10 codes in discharge summaries, and ‘key-words’ search on electronic medical records (EMR). To be included in the analysis, patients had to have a positive RT-PCR for SARS-CoV2 performed in APHP and be admitted in any APHP department between 1^st March 2020 until 31^st December 2020. Patients with past history of any MSK condition were excluded. MSK conditions were considered only if coded or reported in an EMR up to 90 days after the positive RT-PCR. Demographics and disease characteristics including treatment were compared in both groups (MSK yes/no) by T-test or ChiSquare test, accordingly.

Results Among the 55872 patients with a positive SARS-CoV2 RT-PCR performed in APHP, 17771 were admitted in APHP hospitals. Among them, 2170 had a previous history of MSK condition and were therefore excluded from this analysis. Among the remaining 15601 patients, 1370 (8.8%) presented with MSK symptoms. The most prevalent MSK symptoms were low back pain (32.9%), followed by joint pain (29.9%), radicular pain (20.2%) and joint effusion/arthritis (22.8%). Patients with MSK symptoms were older (67y vs. 64y, p<0.01), more frequently obese (29% vs. 25%, p=0.03), hypertensive (34% vs. 30%, p<0.01) and with diabetes (21% vs. 18%, p<0.01). There were no differences on gender nor on the ICU admission rate between groups (31% vs. 29%, NS); 30-days mortality was significantly lower in the MSK+ group probably due to selection bias (i.e. only patients who survived could present with MSK symptoms up to 90 days later) (7.8% vs. 16.9%, p<0.01). Treatment for SARS-CoV2 was slightly different in both groups, with higher corticosteroids (40.7% vs. 29.0%, p<0.01), antivirals (21.5% vs. 15.3%, p<0.01) and immunosuppressive drugs (8.5% vs. 4.5%, p<0.01) prescription rates in the MSK+ group.

Conclusion MSK symptoms occurred in almost 9% of patients admitted to the hospital after a SARS-CoV2 infection, particularly in older and more comorbid patients. Further analysis evaluating the persistence of these symptoms are needed.

Acknowledgements We would like to acknowledge all departments of Rheumatology of APHP

Disclosure of Interests Anna Moltó Consultant of: abbvie, MSD, BMS, Pfizer, Lilly, UCB, GIlead, Jansenn, NOvartis, Grant/research support from: UCB, Pierre Pinson: None declared, Nathanael Beeker: None declared, Christian Roux: None declared