Neuromuscular Disorders in Severe Acute Respiratory Syndrome

Tsai, Li-Kai; Hsieh, Sung‐Tsang; Chao, Chi‐Chao; Chen, Yee‐Chun; Lin, Yu‐Min; Chang, Shan‐Chwen; Chang, Yang-Chyuan

doi:10.1001/archneur.61.11.1669

Cited by 370 publications

(448 citation statements)

References 17 publications

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“…However, the reduced exercise capacity after hospital discharge in SARS survivors could not be accounted for by impairment of pulmonary function alone, 12,13,18,19 whereas extra‐pulmonary causes such as physical deconditioning, muscle weakness and poor motivation were contributing factors. Several reasons for muscle weakness were suggested, including viral‐induced myositis at initial presentation, muscle wasting and deconditioning due to prolonged bed rest, steroid myopathy and critical illness‐associated poly‐neuropathy or myopathy 12,13,18,19,43 …”

Section: Discussionmentioning

confidence: 99%

The long‐term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status

et al. 2010

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Section: Discussionmentioning

confidence: 99%

The long‐term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status

et al. 2010

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“…The functional disability appears out of proportion to the degree of lung function impairment and may be due to extrapulmonary factors such as muscle deconditioning and steroid myopathy [145,146]. Critical-illness-associated polyneuropathy/myopathy has also been observed in a few SARS survivors [147]. The reported incidence rates of avascular necrosis of bone among different cohorts in Hong Kong range from 4.7-15 % [124,148,149], whereas one study from Beijing reported a high incidence of 42 % [123].…”

Section: Long-term Outcomementioning

confidence: 99%

SARS: clinical presentation, transmission, pathogenesis and treatment options

2006

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SARS (severe acute respiratory syndrome) appeared as the first emerging infectious disease of this century. It is fortunate that the culprit virus can be grown without much difficulty from a commonly used cell line, allowing an unlimited supply of isolates for further molecular studies and leading to the development of sensitive diagnostic assays. How the virus has successfully jumped the species barrier is still a mystery. The superspreading events that occurred within hospital, hotel and high-density housing estate opens a new chapter in the mechanisms and routes of virus transmission. The old practice of quarantine proved to be still useful in controlling the global outbreak. Despite all the available sophisticated tests, alertness with early recognition by healthcare workers and prompt isolation of suspected cases is still the most important step for containing the spread of the infection. Although the rapidly evolving outbreak did not allow the conducting of systematic clinical trails to evaluate treatment options, the accumulated experience on managing SARS patients will improve the clinical outcome should SARS return. Although SARS led to more than 700 deaths worldwide, the lessons learnt have prepared healthcare systems worldwide to face future emerging and re-emerging infections.

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“…после выписки из стационара сохранялось снижение физической вы носливости, которое нельзя было объяснить только легочными функциональными нарушениями [27]. Снижение переносимости физических нагрузок у данных больных может быть связано не только с легочными функциональными параметрами, но также с экстралегочными факторами, такими как атрофия скелетных мышц (от бездействия), стероид индуцированная и вирусная миопатия, полиней ропатия / миопатия критических состояний [28], и с другими физиологическими причинами. Эти данные, конечно, отличаются от результатов настоя щего годичного наблюдения.…”

Section: Discussionunclassified

A one-year follow-up study of patients survived after ALI / ARDS caused by influenza A / H1N1

Авдеев¹,

Карчевская²,

Баймаканова³

et al. 2011

Pulʹmonologiâ (Mosk.)

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гг. мы стали свидетелями пандемии, вызванной вирусом гриппа А / H1N1 [1,2]. Панде мический вирус гриппа А / H1N1 отличался по сво ей патогенности от сезонного гриппа по 2 ключевым аспектам: во первых, вирусная инфекция гриппом А / H1N1 чаще всего поражала лиц более молодого возраста, а, во вторых, вирус был способен инфици ровать нижние дыхательные пути и вызвать быстро прогрессирующую пневмонию и острую дыхатель ную недостаточность (ОДН) [3]. В сезон пандемии гриппа A / H1N1 от 1 % до 10 % всех пациентов нуж дались в госпитализации, и общая летальность боль ных составила ~ 0,5 % [4]. При анализе данных боль ных гриппом A / H1N1, находившихся в отделениях интенсивной терапии (ОРИТ) разных городов РФ и разных стран, обращало на себя внимание рази тельное сходство этих пациентов: молодой возраст (в среднем 30-40 лет), очень высокая потребность в искусственной вентиляции легких (ИВЛ) (70-100 %) и очень высокая летальность (17-50 %) [5]. This was an open, prospective, 12 month study involved 22 patients survived from ALI / ARDS caused by influenza A / H1N1. The patients' lung function, arterial blood gases, physical tolerance in 6 min walking test (6MWT) and computed tomography (CT) of the lungs were monitored in 3, 6, and 12 months after discharge. During the follow up, all lung function parameters improved: FVC, TLC, and DLCO increased by 28.7 %, 17.5 % and 31.4 %, respectively (p < 0.05 for all). In a year after discharge, DLCO < 80 %pred. was found in 23 % of patients. At 12 months, the mean 6MWT distance increased from 454 ± 37 to 568 ± 47 m (р = 0.002). Significant improvement was noted in CT findings and 41% of patients had quite normal lung CT at 12 months. Therapy with NAC (n = 11) has led to more rapid improvement in DLCO (76.3 ± 11.8 %pred. vs 63.0 ± 10.6 %pred. in controls; р = 0.012) and 6MWT distance (533 ± 42 m vs 490 ± 46 m, respectively; р = 0.033) at 3 months. Therefore, patients survived from ALI / ARDS caused by influenza A / H1N1 demonstrated significant recovery of lung function, gas exchange, lung CT picture and physical tolerance but in some of them, persistent disorders of lung function (mainly in DLCO) and lung CT have been still found at 1 year after discharge. Treatment with NAC allowed more rapid improvement in DLCO and exercise tolerance. Key words: N acetylcysteine, influenza, acute respiratory distress syndrome. РезюмеЗадачей исследования было изучение долгосрочных последствий у больных, переживших острое повреждение легких / острый респираторный дистресс синдром (ОПЛ / ОРДС), вызванный вирусом гриппа A / H1N1, а также анализ влияния длительной терапии N ацетилцистеином -NAC (Флуимуцил, Zambon Group, Италия) на динамику клинических и функциональных изменений у данных пациентов. Исследование длительностью 12 мес. имело проспективный, открытый дизайн. В него были включены 22 больных, перенесших ОПЛ / ОРДС, вызванный вирусом гриппа A / H1N1. Через 3, 6 и 12 мес. после выписки пациентам проводились измерение функции внешнего дыхания (ФВД), газовый анализ артериальной крови, 6 минутный шаг...

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Neuromuscular Disorders in Severe Acute Respiratory Syndrome

Abstract: The neuromuscular problems in patients with SARS are considered to be critical-illness polyneuropathy or myopathy, possibly coexistent. Further pathological and microbiological studies are necessary to determine the relationship between SARS coronavirus and neuromuscular problems.

Cited by 370 publications

References 17 publications

The long‐term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status

The long‐term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status

SARS: clinical presentation, transmission, pathogenesis and treatment options

A one-year follow-up study of patients survived after ALI / ARDS caused by influenza A / H1N1

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