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Subclinical myopathic changes in COVID-19.

Davide Villa1,2, Gianluca Ardolino1, Linda Borellini3

  • 1U.O. Neurofisiopatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
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PubMed
Summary

Subtle muscle damage can occur in patients with coronavirus disease 2019 (COVID-19), even without obvious symptoms. Electromyography revealed myopathic changes in half of the evaluated patients, suggesting muscle involvement is part of the COVID-19 spectrum.

Keywords:
COVID-19ElectromyographyMuscle injuryMyopathySARS-Cov-2

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Musculoskeletal System

Background:

  • Neuromuscular symptoms affect up to 10.7% of hospitalized coronavirus disease 2019 (COVID-19) patients.
  • The extent of muscle involvement in COVID-19 patients without overt myopathy remains understudied using neurophysiological methods.

Purpose of the Study:

  • To investigate subclinical muscular involvement in hospitalized COVID-19 patients using neurophysiological techniques.
  • To assess the presence of myopathic changes in COVID-19 patients without clinical signs of muscle disease.

Main Methods:

  • Evaluated 12 hospitalized COVID-19 patients (excluding those on ventilation or steroids) over 3 weeks.
  • Performed nerve conduction studies (NCS) on tibial, ulnar, sural, and radial nerves.
  • Conducted needle electromyography (EMG) on 8 selected muscles to assess spontaneous activity, morphology, and motor unit action potentials (MUAPs).

Main Results:

  • Nerve conduction studies (NCS) showed no abnormalities.
  • Needle electromyography (EMG) revealed myopathic changes in 6 out of 12 patients (50%).
  • Patients with myopathic changes were clinically asymptomatic for muscle involvement, with similar clinical and laboratory findings compared to unaffected patients.

Conclusions:

  • Muscle involvement can occur in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection without clinical manifestation and is part of the disease spectrum.
  • Further research, including muscle biopsy, is recommended to understand the mechanisms of muscle damage and guide treatment for coronavirus-mediated injury.