Abstract
Many critically ill patients infected with SARS-CoV-2 have been submitted to an intensive care unit (ICU). Patients with a SARS-CoV-2 infection that survive critical illness are confronted with months of physical impairments. To maximize recovery, it is important to understand the musculoskeletal involvement in critically ill patients infected with SARS-CoV-2. The aim of the present study was to assess the myocellular changes in SARS-CoV-2 patients that occur throughout the first week of ICU admission. In n = 22 critically ill patients infected with SARS-CoV-2, a biopsy sample from the vastus lateralis muscle was obtained at day 1-3 and day 5-8 following ICU admission. Fluorescence microscopy was used to assess type I and type II muscle fiber size and distribution, myonuclear content, and muscle tissue capillarization. Transmission electron microscopy was used to support quantitative data at an ultrastructural level. Changes in type I and type II muscle fiber size showed large inter-individual variation. The average change in type I fiber size was +309 +/- 1834 mu m(2), ranging from -2129 mu m(2) (-31%) to +3375 mu m(2) (+73%). The average change in type II fiber size was -224 +/- 1256 mu m(2), ranging from -1410 mu m(2) (-36%) to +2592 mu m(2) (+48%). Ultrastructural observations showed myofibrillar and hydropic degeneration, and fiber necrosis. This study shows that ICU patients admitted with SARS-CoV-2 suffer from substantial muscle fiber damage during ICU admission. These results are a call for action towards more specialized rehabilitation programs for patients admitted to the ICU with SARS-CoV-2 infection.
Original language | English |
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Article number | 7310 |
Number of pages | 18 |
Journal | Applied Sciences |
Volume | 12 |
Issue number | 14 |
DOIs | |
Publication status | Published - 1 Jul 2022 |
Keywords
- severe acute respiratory syndrome virus
- skeletal muscles
- sepsis
- respiratory distress syndrome
- critical illness
- ELECTRON-MICROSCOPY
- ACQUIRED WEAKNESS
- FIBER
- CONSEQUENCES
- MANAGEMENT
- COVID-19
- ACE2