Approach to Critical Illness Myopathy and Polyneuropathy in the Older SARS-CoV-2 Patients

Overview

Journal J Clin Neurosci

Specialty Neurology

Date 2020 Oct 19

PMID 33070904

Citations 13

Authors

Brendan McClafferty

Ibrahim Umer

Gary Fye

Douglas Kepko

Ricci Kalayanamitra

Zainab Shahid

Devyani Ramgobin

Alice Cai

Andrew Groff

Abani Bhandari

Chander Shekher Aggarwal

Ravi Patel

Dhirisha Bhatt

Hyma Polimera

Nitasa Sahu

Ramarao Vunnam

Reshma Golamari

Ashutosh Kumar

Rohit Jain

Affiliations

Soon will be listed here.

Abstract

One of the major concerns of the health care community and the public surrounding the SARS-CoV-2 pandemic is the availability and use of ventilators. Unprecedented surges of patients presented to intensive care units across the country, with older adults making up a large proportion of the patient population. This paper illustrates contemporary approaches to critical illness myopathy (CIM), critical illness polyneuropathy (CIP), and critical illness polyneuromyopathy (CIPNM) in older patients, including incidence, risk factors, mechanisms for pathology, diagnosis, contemporary treatment approaches, and outcomes. We hope that the following analysis may help educate clinicians and ultimately decrease the duration of the mechanical ventilation required by these patients, resulting in improved clinical outcomes and an increase in ventilator availability for other patients in need.

Citing Articles

Potential diagnostic tools for intensive care unit acquired weakness: A systematic review.

Xin C, Gai Y, Wei L, Wang Y, Luo Y, Han B Int J Nurs Stud Adv. 2025; 8:100301.

PMID: 39995749 PMC: 11849193. DOI: 10.1016/j.ijnsa.2025.100301.

Baseline Characteristics and Outcomes for People With and Without COVID-19 Diagnoses Receiving Inpatient Rehabilitation Care Across the US in 2020-2021.

Charbonneau E, Grover P, Johns J, McDowell S, Stillo J Arch Rehabil Res Clin Transl. 2023; 5(3):100281.

PMID: 37744204 PMC: 10517355. DOI: 10.1016/j.arrct.2023.100281.

Comparing Neuro-COVID-19 between Waves Requires Clear Cohort Selection.

Finsterer J, Scorza F Ann Indian Acad Neurol. 2023; 26(3):304-305.

PMID: 37538437 PMC: 10394432. DOI: 10.4103/aian.aian_11_23.

Short-Term Outcomes of the First-Session Prone Position in Patients With Severe Coronavirus Disease 2019: A Retrospective Chart Review.

Onji M, Kakizoe S, Nakai A, Shimizu K, Masui Y, Naito K Cureus. 2023; 15(2):e35437.

PMID: 36994294 PMC: 10041127. DOI: 10.7759/cureus.35437.

Intensive care unit-acquired weakness: A review from molecular mechanisms to its impact in COVID-2019.

Gonzalez A, Abrigo J, Achiardi O, Simon F, Cabello-Verrugio C Eur J Transl Myol. 2022; 32(3).

PMID: 36036350 PMC: 9580540. DOI: 10.4081/ejtm.2022.10511.

References

Waclawik A, Sufit R, Beinlich B, Schutta H . Acute myopathy with selective degeneration of myosin filaments following status asthmaticus treated with methylprednisolone and vecuronium. Neuromuscul Disord. 1992; 2(1):19-26. DOI: 10.1016/0960-8966(92)90022-x. View

Jung B, Moury P, Mahul M, De Jong A, Galia F, Prades A . Diaphragmatic dysfunction in patients with ICU-acquired weakness and its impact on extubation failure. Intensive Care Med. 2015; 42(5):853-861. DOI: 10.1007/s00134-015-4125-2. View

Piva S, Fagoni N, Latronico N . Intensive care unit-acquired weakness: unanswered questions and targets for future research. F1000Res. 2019; 8. PMC: 6480958. DOI: 10.12688/f1000research.17376.1. View

Koch S, Spuler S, Deja M, Bierbrauer J, Dimroth A, Behse F . Critical illness myopathy is frequent: accompanying neuropathy protracts ICU discharge. J Neurol Neurosurg Psychiatry. 2010; 82(3):287-93. DOI: 10.1136/jnnp.2009.192997. View

Tseng C, Perrone L, Zhu H, Makino S, Peters C . Severe acute respiratory syndrome and the innate immune responses: modulation of effector cell function without productive infection. J Immunol. 2005; 174(12):7977-85. DOI: 10.4049/jimmunol.174.12.7977. View

Hund E . Neurological complications of sepsis: critical illness polyneuropathy and myopathy. J Neurol. 2002; 248(11):929-34. DOI: 10.1007/s004150170043. View

Latronico N, Shehu I, Seghelini E . Neuromuscular sequelae of critical illness. Curr Opin Crit Care. 2005; 11(4):381-90. DOI: 10.1097/01.ccx.0000168530.30702.3e. View

Latronico N, Bolton C . Critical illness polyneuropathy and myopathy: a major cause of muscle weakness and paralysis. Lancet Neurol. 2011; 10(10):931-41. DOI: 10.1016/S1474-4422(11)70178-8. View

Shi S, Peng J, Li Y, Qin C, Liang G, Xu L . The expression of membrane protein augments the specific responses induced by SARS-CoV nucleocapsid DNA immunization. Mol Immunol. 2006; 43(11):1791-8. PMC: 7112551. DOI: 10.1016/j.molimm.2005.11.005. View

10.

Nydahl P, Sricharoenchai T, Chandra S, Kundt F, Huang M, Fischill M . Safety of Patient Mobilization and Rehabilitation in the Intensive Care Unit. Systematic Review with Meta-Analysis. Ann Am Thorac Soc. 2017; 14(5):766-777. DOI: 10.1513/AnnalsATS.201611-843SR. View

11.

Larsson L, Li X, Edstrom L, Eriksson L, Zackrisson H, Argentini C . Acute quadriplegia and loss of muscle myosin in patients treated with nondepolarizing neuromuscular blocking agents and corticosteroids: mechanisms at the cellular and molecular levels. Crit Care Med. 2000; 28(1):34-45. DOI: 10.1097/00003246-200001000-00006. View

12.

Mitobe Y, Morishita S, Ohashi K, Sakai S, Uchiyama M, Abeywickrama H . Skeletal Muscle Index at Intensive Care Unit Admission Is a Predictor of Intensive Care Unit-Acquired Weakness in Patients With Sepsis. J Clin Med Res. 2019; 11(12):834-841. PMC: 6879036. DOI: 10.14740/jocmr4027. View

13.

Castilletti C, Bordi L, Lalle E, Rozera G, Poccia F, Agrati C . Coordinate induction of IFN-alpha and -gamma by SARS-CoV also in the absence of virus replication. Virology. 2005; 341(1):163-9. PMC: 7111739. DOI: 10.1016/j.virol.2005.07.015. View

14.

Weijs P, Looijaard W, Dekker I, Stapel S, Girbes A, Oudemans-van Straaten H . Low skeletal muscle area is a risk factor for mortality in mechanically ventilated critically ill patients. Crit Care. 2014; 18(2):R12. PMC: 4028783. DOI: 10.1186/cc13189. View

15.

Mozaffar T, Haddad F, Zeng M, Zhang L, Adams G, Baldwin K . Molecular and cellular defects of skeletal muscle in an animal model of acute quadriplegic myopathy. Muscle Nerve. 2006; 35(1):55-65. DOI: 10.1002/mus.20647. View

16.

Jang M, Shin M, Shin Y . Pulmonary and Physical Rehabilitation in Critically Ill Patients. Acute Crit Care. 2019; 34(1):1-13. PMC: 6849048. DOI: 10.4266/acc.2019.00444. View

17.

Muangmingsuk S, Ingram P, Gupta M, ARCILLA R, Gupta M . Dexamethasone induced cardiac hypertrophy in newborn rats is accompanied by changes in myosin heavy chain phenotype and gene transcription. Mol Cell Biochem. 2000; 209(1-2):165-73. DOI: 10.1023/a:1007128300430. View

18.

Witteveen E, Sommers J, Wieske L, Doorduin J, van Alfen N, Schultz M . Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study. Ann Intensive Care. 2017; 7(1):40. PMC: 5382120. DOI: 10.1186/s13613-017-0263-8. View

19.

Garg S, Kim L, Whitaker M, OHalloran A, Cummings C, Holstein R . Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 - COVID-NET, 14 States, March 1-30, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(15):458-464. PMC: 7755063. DOI: 10.15585/mmwr.mm6915e3. View

20.

Zheng Y, Wang Q . [Bioinformatics analysis on molecular mechanism of ribavirin and interferon-α in treating MERS-CoV]. Zhonghua Liu Xing Bing Xue Za Zhi. 2016; 37(2):291-3. DOI: 10.3760/cma.j.issn.0254-6450.2016.02.028. View