{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T14:56:46Z","timestamp":1778857006510,"version":"3.51.4"},"reference-count":120,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health, National Institute on Aging","award":["3P01AG036675-13S1"],"award-info":[{"award-number":["3P01AG036675-13S1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The COVID-19 pandemic has revealed significant secondary complications affecting musculoskeletal (MSK) health, especially in patients with pre-existing conditions. This review synthesizes data from clinical and experimental studies on key MSK biomarkers, including cartilage oligomeric matrix protein (COMP), hyaluronic acid (HA), osteocalcin, alkaline phosphatase (ALP), procollagen type I N-terminal peptide (PINP), osteopontin (OPN), matrix metalloproteinases (MMP-3 and MMP-9), myostatin, IGF-1, follistatin, and creatine kinase. COVID-19 is associated with decreased COMP and osteocalcin levels, indicating cartilage degradation and impaired bone formation, alongside elevated HA, ALP, PINP, OPN, and MMPs, reflecting increased joint inflammation, bone remodeling, and tissue breakdown. Changes in myostatin, IGF-1, follistatin, and creatine kinase levels have been shown to be linked with COVID-19-related sarcopenia. These biomarker alterations provide insight into the underlying mechanisms of MSK damage in COVID-19 patients and highlight the potential for using these markers in early diagnosis and management of post-COVID musculoskeletal disorders. Further longitudinal research is essential to develop targeted therapies aimed at mitigating long-term MSK complications in affected individuals.<\/jats:p>","DOI":"10.3390\/ijms26178569","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T09:18:57Z","timestamp":1756977537000},"page":"8569","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Musculoskeletal Complications in COVID-19: Exploring the Role of Key Biomarkers"],"prefix":"10.3390","volume":"26","author":[{"given":"Sagar","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Medicine, Augusta University, Augusta, GA 30912, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8736-4292","authenticated-orcid":false,"given":"Cameron","family":"Foster","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, College of Medicine, University of Florida, Jacksonville, FL 32209, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamal","family":"Patel","sequence":"additional","affiliation":[{"name":"School of Dentistry, University of Alabama at Birmingham, 1919 7th Ave S, Birmingham, AL 35233, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monte","family":"Hunter","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Augusta University, Augusta, GA 30912, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4480-3484","authenticated-orcid":false,"given":"Carlos M.","family":"Isales","sequence":"additional","affiliation":[{"name":"Department of Medicine, Augusta University, Augusta, GA 30912, USA"},{"name":"Department of Orthopaedic Surgery, Augusta University, Augusta, GA 30912, USA"},{"name":"Center for Healthy Aging, Augusta University, Augusta, GA 30912, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadanand","family":"Fulzele","sequence":"additional","affiliation":[{"name":"Department of Medicine, Augusta University, Augusta, GA 30912, USA"},{"name":"Department of Orthopaedic Surgery, Augusta University, Augusta, GA 30912, USA"},{"name":"Center for Healthy Aging, Augusta University, Augusta, GA 30912, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.biochi.2020.09.018","article-title":"The emergence of COVID-19 as a global pandemic: Understanding the epidemiology, immune response and potential therapeutic targets of SARS-CoV-2","volume":"179","author":"Muralidar","year":"2020","journal-title":"Biochimie"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Khan, M., Adil, S.F., Alkhathlan, H.Z., Tahir, M.N., Saif, S., Khan, M., and Khan, S.T. 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