Impact of COVID-19 on Diaphragmatic Function: Understanding Multiorgan Involvement and Long-Term Consequences

Area of Science:

• Respiratory Physiology
• Neurology
• Immunology

Background:

• COVID-19 primarily impacts the respiratory system, yet the diaphragm's role in long COVID remains understudied.
• The diaphragm is crucial for respiration, posture, and autonomic nervous system regulation.
• SARS-CoV-2 infection can lead to multi-system complications, including those affecting the diaphragm.

Purpose of the Study:

• To review the diaphragm's role in respiratory health and disease, particularly in long COVID.
• To explore the mechanisms of diaphragmatic dysfunction post-SARS-CoV-2 infection.
• To highlight diagnostic challenges and potential therapeutic avenues for diaphragmatic involvement in long COVID.

Main Methods:

• Comprehensive literature review of studies on COVID-19, long COVID, and diaphragmatic function.
• Analysis of the impact of SARS-CoV-2 on neurological, musculoskeletal, and inflammatory pathways affecting the diaphragm.
• Examination of diaphragmatic dysfunction's contribution to specific long COVID symptoms.

Main Results:

• SARS-CoV-2 can directly and indirectly impair diaphragm function through neuroinvasion, inflammation, and viral effects.
• Diaphragmatic dysfunction is implicated in symptoms like voice disorders, pelvic floor issues, and sleep disturbances in long COVID.
• Current diagnostic methods for diaphragmatic dysfunction are complex and require differentiation from other conditions.

Conclusions:

• The diaphragm plays a significant, multifaceted role in the pathophysiology of long COVID.
• Addressing diaphragmatic dysfunction is crucial for a comprehensive approach to long COVID diagnosis and treatment.
• This review offers a novel, multisystem perspective on diaphragmatic dysfunction in the context of COVID-19 and its sequelae.