Skip to main content
. 2022 May 4;10(5):1068. doi: 10.3390/biomedicines10051068

Figure 2.

Figure 2

Potential effects, risk factors, and potential biomarkers of SARS-CoV-2 infection into skeletal muscle. Viral infection or cytokine storm can lead to multiorgan injury, including skeletal muscle damage through multiple pathways (see text). Risk factors for developing COVID-19 are reported. They include aging, malnutrition, vitamin D3 deficiency, neuromuscular diseases such as myasthenia gravis, multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS), high expression of ACE-2, or high levels of reactive oxygen species (ROS). Skeletal muscle symptoms of damage could lead to increase in typical biochemical markers of tissue damage and inflammation such as creatine kinase (CK) and protein C-reactive (PCR). Several sphingolipid metabolites and enzymes have been proposed as biochemical markers. Ceramide (Cer), sphingosine (Sph), sphingosine 1-phosphate (S1P), ceramide synthase (CerS), and sphingomyelin (SM). ? indicates that direct infection of SARS-CoV-2 into muscle skeletal cells is still to be demonstrated. VitD, Vitamin D.