Muscle pain in the context of Amplified musculoskeletal pain syndrome

The symptoms of COVID-19 are variable depending on the type of variant contracted, ranging from mild symptoms to a potentially fatal illness. Common symptoms include coughing, fever, loss of smell and taste, with less common ones including headaches, nasal congestion and runny nose, muscle pain, sore throat, diarrhea, eye irritation, and toes swelling or turning purple, and in moderate to severe cases, breathing difficulties. People with the COVID-19 infection may have different symptoms, and their symptoms may change over time.

Three common clusters of symptoms have been identified: a respiratory symptom cluster with cough, sputum, shortness of breath, and fever; a musculoskeletal symptom cluster with muscle and joint pain, headache, and fatigue; and a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhea. In people without prior ear, nose, or throat disorders, loss of taste combined with loss of smell is associated with COVID-19 and is reported in as many as 88% of symptomatic cases.

Hyperkalemia is an elevated level of potassium (K) in the blood. Normal potassium levels are between 3.5 and 5.0 mmol/L (3.5 and 5.0 mEq/L) with levels above 5.5 mmol/L defined as hyperkalemia. Typically hyperkalemia does not cause symptoms. Occasionally when severe it can cause palpitations, muscle pain, muscle weakness, or numbness. Hyperkalemia can cause an abnormal heart rhythm which can result in cardiac arrest and death.

Common causes of hyperkalemia include kidney failure, hypoaldosteronism, and rhabdomyolysis. A number of medications can also cause high blood potassium including mineralocorticoid receptor antagonists (e.g., spironolactone, eplerenone and finerenone) NSAIDs, potassium-sparing diuretics (e.g., amiloride), angiotensin receptor blockers, and angiotensin converting enzyme inhibitors. The severity is divided into mild (5.5 – 5.9 mmol/L), moderate (6.0 – 6.5 mmol/L), and severe (> 6.5 mmol/L). High levels can be detected on an electrocardiogram (ECG), though the absence of ECG changes does not rule out hyperkalemia. The measurement properties of ECG changes in predicting hyperkalemia are not known. Pseudohyperkalemia, due to breakdown of cells during or after taking the blood sample, should be ruled out.

Chikungunya is an infection caused by the chikungunya virus. The most common symptoms are fever and joint pain, typically occurring four to eight days after the bite of an infected mosquito; however some people may be infected without showing any symptoms. Other symptoms may include headache, muscle pain, joint swelling, and a rash. Symptoms usually improve within a week; however, occasionally the joint pain may last for months or years. The very young, old, and those with other health problems are at risk of more severe disease.

The virus is spread between people by two species of mosquito in the genus Aedes: Aedes albopictus and Aedes aegypti, which mainly bite during the day, particularly around dawn and in the late afternoon. The virus may circulate within a number of animals, including birds and rodents. Diagnosis is done by testing the blood for either viral RNA or antibodies to the virus. The symptoms can be mistaken for those of dengue fever and Zika fever, which are spread by the same mosquitoes. It is believed most people become immune after a single infection.