COVID-19 is associated with distinct myopathic features in the diaphragm of critically ill patients.
BMJ Open Respir Res
; 8(1)2021 09.
Article
in En
| MEDLINE
| ID: mdl-34544735
ABSTRACT
INTRODUCTION:
The diaphragm is the main muscle of inspiration, and its dysfunction contributes to adverse clinical outcomes in critically ill patients. We recently reported the infiltration of SARS-CoV-2, and the development of fibrosis, in the diaphragm of critically ill patients with COVID-19. In the current study, we aimed to characterise myofiber structure in the diaphragm of critically ill patients with COVID-19.METHODS:
Diaphragm muscle specimens were collected during autopsy from patients who died of COVID-19 in three academic medical centres in the Netherlands in April and May 2020 (n=27). We studied diaphragm myofiber gene expression and structure and compared the findings obtained to those of deceased critically ill patients without COVID-19 (n=10).RESULTS:
Myofibers of critically ill patients with COVID-19 showed on average larger cross-sectional area (slow-twitch myofibers 2441±229 vs 1571±309 µm2; fast-twitch myofibers 1966±209 vs 1225±222 µm2). Four critically ill patients with COVID-19 showed extremely large myofibers, which were splitting and contained many centralised nuclei. RNA-sequencing data revealed differentially expressed genes involved in muscle regeneration.CONCLUSION:
Diaphragm of critically ill patients with COVID-19 has distinct myopathic features compared with critically ill patients without COVID-19, which may contribute to the ongoing dyspnoea and fatigue in the patients surviving COVID-19 infection.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Diaphragm
/
Critical Illness
/
COVID-19
Type of study:
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
BMJ Open Respir Res
Year:
2021
Document type:
Article
Affiliation country:
Netherlands