Short of Breath for the Long Haul: Diaphragm Muscle Dysfunction in Survivors of Severe COVID-19 as Determined by Neuromuscular Ultrasound

Farr, E.; Wolfe, A. R.; Deshmukh, S.; Rydberg, L.; Soriano, R.; Walter, J. M.; Boon, A. J.; Wolfe, L. F.; Franz, C. K.

Many survivors from acute respiratory distress syndrome (ARDS) associated with coronavirus disease 2019 (COVID-19) suffer from persistent dyspnea and fatigue long after resolution of the active infection. In a cohort of 25 consecutive COVID-19 ARDS survivors admitted to an inpatient rehabilitation hospital (76% male), 80% of them had at least one sonographic abnormality of diaphragm muscle structure or function. Specifically, when compared to established normative data, 76% had impaired contractility (reduced thickening ratio), and 20% patients had atrophy (reduced muscle thickness). These findings support neuromuscular respiratory dysfunction as a highly prevalent underlying cause for prolonged functional impairments after hospitalization for COVID-19.