[Diaphragmatic dysfunction post-COVID-19 infection: report of two cases]

Area of Science:

• Neurology
• Pulmonology
• Infectious Diseases

Background:

• The COVID-19 pandemic has led to various multi-system complications and long-term sequelae.
• Diaphragm dysfunction is an underrecognized post-COVID-19 symptom, with limited reports globally and none in China.

Observation:

• Two patients presented with respiratory distress following COVID-19 infection.
• Dynamic chest radiographs revealed diaphragm dysfunction upon admission.
• Further investigations included diaphragm ultrasound, neurophysiological tests, pressure measurements, MRI, and autoimmune antibody testing.

Findings:

• The final diagnoses were severe myasthenia gravis and diaphragmatic nerve/muscle involvement, both induced by COVID-19 infection.
• Both patients demonstrated symptom improvement following appropriate treatment.

Implications:

• This case series highlights diaphragm dysfunction as a potential sequela of COVID-19.
• It underscores the importance of considering neurological and muscular complications in post-COVID-19 respiratory distress.
• Provides clinical evidence for improved diagnosis and treatment strategies for this rare condition.