COVID-19 Through the Eyes of a Physiatrist: Back Pain Can Be a Symptom and May Predict Pneumonia in COVID-19
Full Text


Coronavirus Disease 2019 (Covid-19)
Back Pain

How to Cite

Uz, C. (2022). COVID-19 Through the Eyes of a Physiatrist: Back Pain Can Be a Symptom and May Predict Pneumonia in COVID-19 . Galician Medical Journal, 29(4), E202241.


The study aimed to determine whether back pain is a clinical manifestation in patients with COVID-19 and whether several demographic and disease characteristics could be an effective indicator of back pain.

Materials and Methods. A total of 99 patients with COVID-19 were recruited from the Department of Infectious Diseases of the Kirikkale High Specialized Hospital in Turkey and divided into two groups depending on the presence (n=50) or absence of back pain (n=49). The primary outcomes included were demographic and disease characteristics, the Nord-Trøndelag Health Study Physical Activity Level for Work (HUNT), and the 6-minute walking test.

Results. The most common symptom was fatigue (n=63, 63.6%), followed by back pain (n=50, 50.5%). In the back pain group, the number of patients with sedentary lifestyle, oxygen requirement, pneumonia, and typical pneumonia pattern were significantly higher (p=0.009, p=0.026, p=0.001, p=0.001, respectively), while aerobic capacity was lower (p=0.001). In a logistic regression analysis, back pain was found to be associated with pneumonia presence.

Conclusions. Back pain may be associated with the presence of COVID-19 pneumonia and should be evaluated as its early warning symptom.
Full Text


Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Emergence, transmission, and characteristics of human coronaviruses. Journal of Advanced Research. 2020;24:91–98. Available from:

van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. New England Journal of Medicine. 2020;382(16):1564–1567. Available from:

Deng Y, Liu W, Liu K, Fang Y-Y, Shang J, Zhou L, et al. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 in Wuhan, China: a retrospective study. Chinese Medical Journal. 2020;133(11):1261–1267. Available from:

Liu W, Tao Z-W, Wang L, Yuan M-L, Liu K, Zhou L, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chinese Medical Journal. 2020;133(9):1032–1038. Available from:

Colavita F, Lapa D, Carletti F, Lalle E, Bordi L, Marsella P, et al. SARS-CoV-2 isolation from ocular secretions of a patient with COVID-19 in Italy With prolonged viral RNA detection. Annals of Internal Medicine. 2020;173(3):242–243. Available from:

Annweiler C, Sacco G, Salles N, Aquino J-P, Gautier J, Berrut G, et al. National French survey of coronavirus disease (COVID-19) symptoms in people aged 70 and over. Clinical Infectious Diseases. 2020;72(3):490–4. Available from:

Avula A, Nalleballe K, Narula N, Sapozhnikov S, Dandu V, Toom S, et al. COVID-19 presenting as stroke. Brain, Behavior, and Immunity. 2020;87:115–119. Available from:

Yue H, Bai X, Wang J, Yu Q, Liu W, et al. Clinical characteristics of coronavirus disease 2019 in Gansu province, China. Annals of Palliative Medicine. 2020;9(4):1404–1412. Available from:

Kurtze N, Rangul V, Hustvedt B-E, Flanders WD. Reliability and validity of self-reported physical activity in the Nord-Trøndelag Health Study — HUNT 1. Scandinavian Journal of Public Health. 2008;36(1):52–61. Available from:

RSNA Journals. Special focus: COVID-19, 2019 Novel Coronavirus. Cook, IL, USA: Radiological Society of North America; 2020. Available from:

American College of Radiology. ACR recommendations for the use of Chest Radiography and Computed Tomography (CT) for suspected COVID-19 Infection [Internet]. March 11, 2020 [cited 2022 Sep 1]. Available from:

Rockx B, Kuiken T, Herfst S, Bestebroer T, Lamers MM, Oude Munnink BB, et al. Comparative pathogenesis of COVID-19, MERS, and SARS in a nonhuman primate model. Science. 2020;368(6494):1012–1015. Available from:

Wan S, Xiang Y, Fang W, Zheng Y, Li B, Hu Y, et al. Clinical features and treatment of COVID‐19 patients in northeast Chongqing. Journal of Medical Virology. 2020;92(7):797–806. Available from:

Zarifian A, Ghasemi Nour M, Akhavan Rezayat A, Rahimzadeh Oskooei R, Abbasi B, Sadeghi R. Chest CT findings of coronavirus disease 2019 (COVID-19): a comprehensive meta-analysis of 9907 confirmed patients. Clinical Imaging. 2021;70:101–110. Available from:

Lee RW, Hodgson LE, Jackson MB, Adams N, et al. Problem based review: Pleuritic Chest Pain. Acute Medicine Journal. 2012;11(3):172–82. Available from:

Ramadurai D, Kelmenson DA, Smith J, Dee E, Northcutt N. Progressive dyspnea and back pain after complicated pneumonia. Annals of the American Thoracic Society. 2017;14(11):1714–1717. Available from:

Crisafulli A, Pagliaro P. Physical activity/inactivity and COVID-19. European Journal of Preventive Cardiology. 2020;28(16):e24–6. Available from:

Dogra S, Good J, Buman MP, Gardiner PA, Stickland MK, Copeland JL. Movement behaviours are associated with lung function in middle-aged and older adults: a cross-sectional analysis of the Canadian longitudinal study on aging. BMC Public Health. 2018;18(1):818. Available from:

Burr JF, Davidson W, Shephard RJ, Eves N. Physical activity in chronic respiratory conditions: assessing risks for physical activity clearance and prescription. Canadian Family Physician. 2012;58(7):761-764. Available from:

Kuder MM, Clark M, Cooley C, Prieto-Centurion V, Danley A, Riley I, et al. A systematic review of the effect of physical activity on asthma outcomes. The Journal of Allergy and Clinical Immunology: In Practice. 2021;9(9):3407-3421.e8. Available from:

Zheng C, Huang WY, Sheridan S, Sit CH-P, Chen X-K, Wong SH-S. COVID-19 pandemic brings a sedentary lifestyle in young adults: a cross-sectional and longitudinal study. International Journal of Environmental Research and Public Health. 2020;17(17):6035. Available from:

Musa S, Elyamani R, Dergaa I. COVID-19 and screen-based sedentary behaviour: systematic review of digital screen time and metabolic syndrome in adolescents. PLOS ONE. 2022;17(3):e0265560. Available from:

Dwyer MJ, Pasini M, De Dominicis S, Righi E. Physical activity: benefits and challenges during the COVID‐19 pandemic. Scandinavian Journal of Medicine & Science in Sports. 2020;30(7):1291–1294. Available from:

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497–506. Available from:

Xie Y, Wang X, Yang P, Zhang S. COVID-19 complicated by acute pulmonary embolism. Radiology: Cardiothoracic Imaging. 2020;2(2):e200067. Available from:

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.