COVID-19 is associated with distinct myopathic features in the diaphragm of critically ill patients.
COVID-19 is associated with distinct myopathic features in the diaphragm of critically ill patients.
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DOI：
10.1136/bmjresp-2021-001052
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发表时间：
2021-09
影响因子：
4.1
通讯作者：
Ottenheijm CAC
中科院分区：
文献类型：
--
作者：
Shi Z;Bogaards SJP;Conijn S;Onderwater Y;Espinosa P;Bink DI;van den Berg M;van de Locht M;Bugiani M;van der Hoeven H;Boon RA;Heunks L;Ottenheijm CAC
膈肌是主要的吸气肌，其功能障碍是危重患者不良临床结果的重要因素。我们最近报道了COVID-19危重患者膈膜中SARS-CoV-2的浸润和纤维化的发展。在目前的研究中，我们的目的是表征COVID-19危重患者膈肌的肌纤维结构。2020年4月和5月，在荷兰的三个学术医疗中心（n=27），从死于COVID-19的患者身上采集了横膈肌标本。我们研究了膈肌纤维基因表达和结构，并将结果与未感染COVID-19的死亡危重患者（n=10）进行了比较。新冠肺炎危重患者肌纤维平均横截面积更大（慢肌纤维：2441±229比1571±309µm2；快肌纤维：1966±209比1225±222µm2）。4名新冠肺炎危重患者的肌纤维非常大，正在分裂，并含有许多集中的核。rna测序数据揭示了参与肌肉再生的差异表达基因。COVID-19危重患者膈肌与未感染COVID-19的危重患者相比具有明显的肌病特征，这可能是COVID-19存活患者持续呼吸困难和疲劳的原因。
The diaphragm is the main muscle of inspiration, and its dysfunction contributes to adverse clinical outcomes in critically ill patients. We recently reported the infiltration of SARS-CoV-2, and the development of fibrosis, in the diaphragm of critically ill patients with COVID-19. In the current study, we aimed to characterise myofiber structure in the diaphragm of critically ill patients with COVID-19. Diaphragm muscle specimens were collected during autopsy from patients who died of COVID-19 in three academic medical centres in the Netherlands in April and May 2020 (n=27). We studied diaphragm myofiber gene expression and structure and compared the findings obtained to those of deceased critically ill patients without COVID-19 (n=10). Myofibers of critically ill patients with COVID-19 showed on average larger cross-sectional area (slow-twitch myofibers: 2441±229 vs 1571±309 µm2; fast-twitch myofibers: 1966±209 vs 1225±222 µm2). Four critically ill patients with COVID-19 showed extremely large myofibers, which were splitting and contained many centralised nuclei. RNA-sequencing data revealed differentially expressed genes involved in muscle regeneration. Diaphragm of critically ill patients with COVID-19 has distinct myopathic features compared with critically ill patients without COVID-19, which may contribute to the ongoing dyspnoea and fatigue in the patients surviving COVID-19 infection.
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影响因子：
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