The Possible Impact of COVID-19 on Respiratory Muscles Structure and Functions: A Literature Review

Abstract

The impact of SARS-CoV-2 infection on respiratory muscle functions is an important area of recent enquiry. COVID-19 has effects on the respiratory muscles. The diaphragm muscle is perturbed indirectly due to the mechanical-ventilation-induced-disuse, but also by direct mechanisms linked with SARS-CoV-2 viral infection. In this sense, a deeper understanding of the possible links between COVID-19 and alterations in structure and functions of the respiratory muscles may increase the success rate of preventive and supportive strategies. Ultrasound imaging alongside respiratory muscle strength tests and pulmonary function assessment are valid approaches to the screening and monitoring of disease, for mild to severe patients. The aim of the present review is to highlight the current literature regarding the links between COVID-19 and respiratory muscle functions. We examine from the pathophysiological aspects of disease, up to approaches taken to monitor and rehabilitate diseased muscle. We hope this work will add to a greater understanding of the pathophysiology and disease management of respiratory muscle pathology subsequent to SARS-CoV-2 infection.

Prolonged loss of intercostal muscle mass and its predictors in COVID-19 patients: A retrospective study from tertiary hospital

“…[27][28][29] Mechanical ventilation can lead to disuse atrophy and muscle weakness in the diaphragm. [1] However, our study showed a different outcome: mechanical ventilation was not a predictor of intercostal muscle wasting during follow-up. The impact of mechanical ventilation on intercostal muscles remains uncertain, but we assumed that the relatively small number of patients who underwent mechanical ventilation might have influenced the results of our study.…”

“…Many individuals experience prolonged fatigue, muscle weakness, sleep disturbances, and mood disorders after recovering from COVID-19 pneumonia and subsequently encounter difficulties in having ordinary lives. [1][2][3][4][5][6] If various systemic symptoms and signs persist more than 3 months after SARS-CoV-2 infection and no other disease has been diagnosed, the World Health Organization defines this condition as post-COVID- 19.…”

“…Previous studies have revealed the prognostic significance of chest wall muscle in patients with Medicine COVID-19 pneumonia, and the loss of chest wall mass in initial CT images is an independent prognostic factor for longer hospital stays, the need for mechanical ventilation, and overall survival. [1][2][3][4][5][6]12] In previous studies, the chest wall mass was usually measured in pectoralis muscle, paraspinal muscle or whole skeletal muscle at the thoracic 12th vertebra level (T12). [1][2][3][4][5][6]12] Even though the intercostal muscle plays a crucial role in respiration, the role of intercostal muscle mass in patients with pneumonia has been poorly demonstrated in previous studies.…”

“…[1][2][3][4][5][6]12] In previous studies, the chest wall mass was usually measured in pectoralis muscle, paraspinal muscle or whole skeletal muscle at the thoracic 12th vertebra level (T12). [1][2][3][4][5][6]12] Even though the intercostal muscle plays a crucial role in respiration, the role of intercostal muscle mass in patients with pneumonia has been poorly demonstrated in previous studies. A previous study demonstrated that the loss of intercostal muscle mass on CT is associated with the severity of chronic obstructive pulmonary disease and the extent of emphysema.…”

“…[1–6,12] In previous studies, the chest wall mass was usually measured in pectoralis muscle, paraspinal muscle or whole skeletal muscle at the thoracic 12th vertebra level (T12). [1–6,12]…”