Heterotopic ossification is often associated with trauma and surgery, and infrequently reported with immobilization due to critical illness. We present 2 patients who developed heterotopic ossification following severe COVID-19 infection. Both patients were middle-aged females who were hospitalized for one month or greater due to COVID-19 requiring mechanical ventilation. Both developed shoulder pain and/or stiffness a few months after discharge, with imaging studies clearly illustrating development of heterotopic ossification around the shoulders. The etiology is unclear, with immobilization and hypoxia being the primary considerations. Physical examination and radiography are essential to diagnosis. Awareness of this complication and early diagnosis may help minimize functional impairment.
Keywords: ARDS, acute respiratory distress syndrome; COVID-19; FiO2, fraction of inspired oxygen; GFR, glomerular filtration rate; HO, heterotopic ossification; Heterotopic ossification; Myositis ossificans; NSAIDs, nonsteroidal anti-inflammatory drugs; RT-PCR, reverse transcription polymerase chain reaction; SARS-CoV-2.
© 2020 The Authors. Published by Elsevier Inc. on behalf of University of Washington.