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Respiratory Muscle Dysfunction and Associated Risk Factors Following COVID-19-Related Hospitalisation
Alessia Verduri1, Roberto Tonelli1, Pierluigi Donatelli1
1Respiratory Unit, Hospital Policlinico Modena, Department of Surgical and Medical Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy.
Insights
Respiratory muscle dysfunction is common in severe COVID-19 survivors, linked to non-invasive ventilation use and female gender. Assessment of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) is recommended for post-COVID-19 patients.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Rehabilitation Medicine
Background:
- Long-term respiratory muscle dysfunction is a known complication in COVID-19 survivors.
- Risk factors contributing to this dysfunction remain largely unidentified.
- This study investigated respiratory muscle function and associated factors in hospitalized COVID-19 patients with acute respiratory failure.
Purpose of the Study:
- To assess respiratory muscle function (MIP/MEP) in COVID-19 survivors.
- To identify independent risk factors associated with respiratory muscle dysfunction.
- To explore correlations between respiratory muscle strength, hand-grip strength, and lung function.
Main Methods:
- A single-center study involving 223 COVID-19 survivors (≥18 years) 3-6 months post-discharge.
- Data collected included respiratory muscle strength (MIP/MEP), hand-grip strength, and lung function parameters (FEV1, FVC, TLC, DLCO).
- Statistical analysis employed logistic regression models to identify risk factors and correlation analyses.
Main Results:
- Over half (54.3%) of patients exhibited MIP or MEP dysfunction.
- Independent risk factors for dysfunction included non-invasive ventilation use (aOR=1.91) and female gender (aOR=1.76).
- MIP dysfunction correlated positively with hand-grip strength; both MIP and MEP correlated significantly with lung function measures.
Conclusions:
- Respiratory muscle dysfunction is prevalent in severe COVID-19 survivors, correlating with peripheral weakness and reduced lung function.
- Non-invasive ventilation during acute illness and female gender are potential risk factors.
- Routine assessment of MIP/MEP is advised for monitoring respiratory muscle function in post-COVID-19 patients.
Background:
Studies have highlighted long-term respiratory muscle dysfunction in COVID-19 survivors, although the underlying risk factors remain unclear. This single-centre study assessed respiratory muscle function and individual associated factors at follow-up in patients hospitalised with COVID-19 and related acute respiratory failure.
Methods:
Data were collected for consecutive patients, aged ≥ 18 years, at the post-COVID outpatient service of Hospital Policlinico in Modena (Italy) in the time frame of 3 to 6 months after discharge. Data were analysed using single and multiple logistic regression models. Correlations among MIP/MEP, hand-grip values, and lung function were further explored.
Results:
Out of 223 patients (mean age 67 years, 69% male) 121 (54.3%) exhibited MIP or MEP dysfunction, which was found to be associated with the use of non-invasive ventilation (aOR = 1.91 [1.07-3.49], p = 0.04) and female gender (aOR = 1.76 [1.09-4.16], p = 0.03) as independent risk factors. A positive correlation was observed between MIP dysfunction and hand-grip strength (p = 0.03 and 0.01), whereas both MIP and MEP were significantly associated with FEV1, FVC, TLC, and DLCO.
Conclusions:
Respiratory muscle dysfunction is consistently prevalent and parallels peripheral muscle weakness and the lung function level in patients at follow-up after severe COVID-19. The need for non-invasive ventilation during the acute phase and female gender might represent risk factors. MIP/MEP assessment should be recommended to observe respiratory muscle dysfunction in severe post-COVID survivors.
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