Critical illness myopathy after COVID-19
Critical illness myopathy after COVID-19
复制标题
DOI：
10.1016/j.ijid.2020.07.072
复制
发表时间：
2020-10-01
影响因子：
8.4
通讯作者：
Rubino, Francesca
中科院分区：
文献类型：
--
作者：
Bagnato, Sergio;Boccagni, Cristina;Rubino, Francesca
本文描述了一名因2019冠状病毒病（COVID-19）长期入住重症监护室（ICU）后出现弥漫性对称性肌无力的患者。患者接受了神经生理学方案，包括神经传导研究、近端和远端肌肉的同心针肌电图（EMG）和直接肌肉刺激（DMS）。神经传导检查显示正常感觉传导和低振幅复合肌肉动作电位（CMAPs）。肌电图显示肌病的迹象，这是更明显的下肢。DMS后CMAP在四头肌中不存在，并且在胫骨前肌中振幅降低。根据这些临床和神经生理学发现，根据现行诊断标准，诊断为重症肌病。鉴于大量COVID-19患者需要长期入住ICU，许多人很可能会出现ICU获得性虚弱，就像这里描述的患者一样。卫生系统必须计划在COVID-19之后为肺部和运动康复治疗提供充分的康复设施。(C)2020作者（S）由爱思唯尔有限公司代表国际传染病学会出版。
This paper describes a patient who developed diffuse and symmetrical muscle weakness after a long stay in the intensive care unit (ICU) due to coronavirus disease 2019 (COVID-19). The patient underwent a neurophysiological protocol, including nerve conduction studies, concentric needle electromyography (EMG) of the proximal and distal muscles, and direct muscle stimulation (DMS). Nerve conduction studies showed normal sensory conduction and low-amplitude compound muscle action potentials (CMAPs). EMG revealed signs of myopathy, which were more pronounced in the lower limbs. The post-DMS CMAP was absent in the quadriceps and of reduced amplitude in the tibialis anterior muscle. Based on these clinical and neurophysiological findings, a diagnosis of critical illness myopathy was made according to the current diagnostic criteria. Given the large number of patients with COVID-19 who require long ICU stays, many are very likely to develop ICU-acquired weakness, as did the patient described here. Health systems must plan to provide adequate access to rehabilitative facilities for both pulmonary and motor rehabilitative treatment after COVID-19. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.