Abstract
As of September 2023, the number of SARS-CoV-2 infections worldwide has exceeded 770 million, with ongoing research recognizing its long-term health effects. This study investigates the effects of the pandemic on participants with and without SARS-CoV-2 infection on musculoskeletal status. The Hamburg City Health Study (HCHS) is an ongoing, prospective, population-based cohort study (trial registration number: NCT03934957). Participants (n = 2660) examined prior to the SARS-CoV-2 pandemic were compared with non-infected participants (n = 2660) in a 1:1 matched cohort analysis after the pandemic onset. Furthermore, participants who had recovered from a SARS-CoV-2 infection (n = 428) were compared with non-infected participants (n = 1712) in 1:4 matched cohort analysis. Increased relative fat mass and reduced skeletal muscle mass were observed in the post-pandemic group. No significant differences were observed between the groups regarding handgrip strength and timed up and go test. The comparison of the infection group with non-infected participants showed no significant differences in relative fat mass, handgrip strength and timed up and go test. The skeletal muscle mass was increased in the infection group but linear regression analysis adjusted for body surface area revealed no significant differences. This prospective study shows no association between SARS-CoV-2 infection and changes in basic musculoskeletal parameters in the cohort studied, suggesting that the infection may not be a significant cause of major deterioration in musculoskeletal function. Instead, it appears that lifestyle changes in daily routines and physical activities associated with the pandemic itself are the main influence on the musculoskeletal system.