COVID-19-Associated Critical Illness Myopathy with Direct Viral Effects.
Dubravka DodigMark A TarnopolskyMarta MargetaKaterina GordonMarvin J FritzlerJian-Qiang LuPublished in: Annals of neurology (2022)
Coronavirus disease 2019 (COVID-19) severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2 infection) can lead to intensive care unit (ICU) admission and critical illness myopathy (CIM). We examined 3 ICU patients with COVID-19 who required mechanical ventilation for pneumonia and developed CIM. Pathological examination of the skeletal muscle biopsies revealed myopathic changes consistent with CIM, variable inflammation with autophagic vacuoles, SARS-CoV immunostaining + fibers/granules, and electron microscopy findings of mitochondrial abnormalities and coronavirus-like particles. Although mitochondrial dysfunction with compromised energy production is a critical pathogenic mechanism of non-COVID-19-associated CIM, in our series of COVID-19-associated CIM, myopathic changes including prominent mitochondrial damage suggest a similar mechanism and association with direct SARS-CoV-2 muscle infection. ANN NEUROL 2022;91:568-574.
Keyphrases
- sars cov
- respiratory syndrome coronavirus
- coronavirus disease
- mechanical ventilation
- intensive care unit
- skeletal muscle
- oxidative stress
- acute respiratory distress syndrome
- respiratory failure
- late onset
- electron microscopy
- emergency department
- cell death
- insulin resistance
- type diabetes
- single cell
- metabolic syndrome
- early onset
- adipose tissue
- extracorporeal membrane oxygenation
- ultrasound guided
- muscular dystrophy
- community acquired pneumonia