COVID-19 is associated with distinct myopathic features in the diaphragm of critically ill patients
Introduction 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 t...
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BMJ Publishing Group
2021-01-01
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| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/8/1/e001052.full |
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| author | Zhonghua Shi Leo Heunks Marianna Bugiani Sylvia J P Bogaards Stefan Conijn Yeszamin Onderwater Pedro Espinosa Diewertje I Bink Marloes van den Berg Martijn van de Locht Hans van der Hoeven Reinier A Boon Coen A C Ottenheijm |
| author_facet | Zhonghua Shi Leo Heunks Marianna Bugiani Sylvia J P Bogaards Stefan Conijn Yeszamin Onderwater Pedro Espinosa Diewertje I Bink Marloes van den Berg Martijn van de Locht Hans van der Hoeven Reinier A Boon Coen A C Ottenheijm |
| author_sort | Zhonghua Shi |
| collection | DOAJ |
| description | Introduction 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.Methods 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).Results 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.Conclusion 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. |
| format | Article |
| id | doaj-art-bfc23ce2954c4e40bccc44b916851940 |
| institution | OA Journals |
| issn | 2052-4439 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Respiratory Research |
| spelling | doaj-art-bfc23ce2954c4e40bccc44b9168519402025-08-20T02:22:20ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392021-01-018110.1136/bmjresp-2021-001052COVID-19 is associated with distinct myopathic features in the diaphragm of critically ill patientsZhonghua Shi0Leo Heunks1Marianna Bugiani2Sylvia J P Bogaards3Stefan Conijn4Yeszamin Onderwater5Pedro Espinosa6Diewertje I Bink7Marloes van den Berg8Martijn van de Locht9Hans van der Hoeven10Reinier A Boon11Coen A C Ottenheijm12Department of Intensive Care Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsDepartment of Intensive Care Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsDepartment of Pathology, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsDepartment of Physiology, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsDepartment of Physiology, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsDepartment of Physiology, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsDepartment of Physiology, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsDepartment of Physiology, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsDepartment of Physiology, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsDepartment of Physiology, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands2 Intensive Care, Radboudumc, Nijmegen, The NetherlandsDepartment of Physiology, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsDepartment of Physiology, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsIntroduction 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.Methods 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).Results 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.Conclusion 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.https://bmjopenrespres.bmj.com/content/8/1/e001052.full |
| spellingShingle | Zhonghua Shi Leo Heunks Marianna Bugiani Sylvia J P Bogaards Stefan Conijn Yeszamin Onderwater Pedro Espinosa Diewertje I Bink Marloes van den Berg Martijn van de Locht Hans van der Hoeven Reinier A Boon Coen A C Ottenheijm COVID-19 is associated with distinct myopathic features in the diaphragm of critically ill patients BMJ Open Respiratory Research |
| title | COVID-19 is associated with distinct myopathic features in the diaphragm of critically ill patients |
| title_full | COVID-19 is associated with distinct myopathic features in the diaphragm of critically ill patients |
| title_fullStr | COVID-19 is associated with distinct myopathic features in the diaphragm of critically ill patients |
| title_full_unstemmed | COVID-19 is associated with distinct myopathic features in the diaphragm of critically ill patients |
| title_short | COVID-19 is associated with distinct myopathic features in the diaphragm of critically ill patients |
| title_sort | covid 19 is associated with distinct myopathic features in the diaphragm of critically ill patients |
| url | https://bmjopenrespres.bmj.com/content/8/1/e001052.full |
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