Infectious agents have been implicated in the pathogenesis of autoimmune disorders for decades. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is no exception. This became evident as the pandemic evolved. Once considered a respiratory pathogen only, SARS-CoV-2 is now linked to a variety of autoimmune rheumatic disorders such as
rheumatoid arthritis,
systemic lupus erythematosus,
reactive arthritis,
spondyloarthropathies,
vasculitis, and
inflammatory myopathy. Although the exact cause for muscle injury in the setting of
coronavirus disease 2019 (COVID-19) is not established, autoimmune inflammatory damage is the most accepted mechanism. Moreover, SARS-CoV-2 can cause direct muscle damage and indirectly through a
cytokine storm. Inflammatory
polymyositis in relation to
COVID-19 has seldom been reported in developing countries. Here, we report a unique case of inflammatory
polymyositis in a 52-year-old lady. The patient presented with
muscle weakness, generalized body
aches, and
fatigue occurring four months after recovering from mild
COVID-19. She had
muscle weakness of Medical Research Council (MRC) grade 3/5 involving the shoulders and pelvic girdle with elevated muscle
enzymes. Electromyography revealed an active irritable myopathic process consistent with inflammatory
polymyositis. She underwent magnetic resonance imaging-guided muscle biopsy from the right thigh which revealed findings consistent with
inflammatory myopathy. She was offered
prednisolone and
azathioprine. After four weeks of treatment, she had a remarkable improvement in her muscle strength to MRC grade 5/5.