How are Lung Volume and Respiratory Muscles Affected in Non-Severe Patients With Covid-19?

Yıl 2022, Cilt: 4 Sayı: 2, 203 - 8, 01.05.2022

İlyas Uçar , Muharrem Said Coşgun , Fatih Çankal , Caner Karartı , Erdal Kurtoğlu Ahmet Payas Dilara Patat , Mehtap Nisari

https://doi.org/10.37990/medr.1078369

Öz

Aim: Coronavirus-2019 (Covid-19) primarily affects the respiratory system, and how it affects respiratory muscles and lung volume is still not fully understood. Our study aimed to assess the time-dependent changes that may occur in lungs and respiratory muscle sizes on chest computed tomography (CT) in adult coronavirus disease 2019 (COVID-19) patients.
Material and Methods: The clinical and radiological records of 101 adult patients who had at least two non-contrast chest CT images in stage 1 (0-4 days) and stage 6 (>28 days) were collected retrospectively. ImFusion Suite program were used to calculate lung volumes, and the cross-sectional areas of the pectoral and intercostal muscles were also calculated using with “ImageJ” program.
Results: One-hundred one patients (51 females, 50.49%) were included in the study. ANCOVA revealed a significant stage*side interaction effect regarding cross-sectional area (CSA) of intercostal muscles [(p=.010; η²p=.064)]. There was no significant difference between the two stages in terms of CSA of pectoralis major and minor muscles [(p=.314; η2p=.010), (p=.644; η²p=.002)] respectively and lung volume [(p=.340; η²p=.009)].
Conclusion: Covid-19 pneumonia causes an atrophy in respiratory muscles. However, it seems to have a nonsignificant effect on auxiliary respiratory muscles and lung volume. Further investigation of respiratory muscles and respiratory muscle training to reduce the risk of serious complications during viral infections are required. 

Anahtar Kelimeler

Covid-19, computed tomography, imaging, lung volume, respiratory muscles

Destekleyen Kurum

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Teşekkür

None.

Akciğer Hacmi ve Solunum Kasları Ağır Seyretmeyen Covid-19 Hastalarında Nasıl Etkilenir?

Öz

Amaç: Coronavirus-2019 (Covid-19) öncelikle solunum sistemini etkiler ve solunum kaslarını ve akciğer hacmini nasıl etkilediği hala tam olarak anlaşılamamıştır. Çalışmamız erişkin koronavirüs hastalığı 2019 (COVID-19) hastalarında akciğer bilgisayarlı tomografisinde (BT) akciğerlerde ve solunum kası boyutlarında zamana bağlı olarak oluşabilecek değişiklikleri değerlendirmeyi amaçladı.
Materyal ve Metot: Evre 1 (0-4 gün) ve evre 6’da (>28 gün) en az iki kontrastsız göğüs BT görüntüsü olan 101 erişkin hastanın klinik ve radyolojik kayıtları geriye dönük olarak toplandı. Akciğer hacimlerini hesaplamak için ImFusion Suite programı kullanıldı ve pektoral ve interkostal kasların kesit alanları da “ImageJ” programı kullanılarak hesaplandı.
Bulgular: Yüz bir hasta (51 kadın, %50,49) çalışmaya dahil edildi. ANCOVA, interkostal kasların kesit alanına (KA) ilişkin önemli bir evre*yan etkileşim etkisi ortaya çıkardı [(p=.010; η²p=.064)]. Sırasıyla pektoralis major ve minor kaslarının KA’sında [(p=.314; η²p=.010), (p=.644; η²p=.002)] ve akciğer hacminde [(p=.340; η²p=.009)] iki evre arasında anlamlı bir fark bulunmadı.
Sonuç: Covid-19 pnömonisi solunum kaslarında atrofiye neden olur. Ancak yardımcı solunum kasları ve akciğer hacmi üzerinde önemsiz bir etkiye sahip olduğu görülmektedir. Viral enfeksiyonlar sırasında ciddi komplikasyon riskini azaltmak için solunum kaslarının daha fazla araştırılması ve solunum kas eğitimi gereklidir.

Anahtar Kelimeler

Covid-19, bilgisayarlı tomografi, görüntüleme, akciğer hacmi, solunum kasları

Kaynakça

• Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. New England Journal of Medicine. 2020;382:727-733.
• Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497-506.
• Xie X, Zhong Z, Zhao W, et al. Chest CT for typical coronavirus disease 2019 (COVID-19) pneumonia: relationship to negative RT-PCR testing. Radiology. 2020;296(2):E41-E45.
• Çağan Ö, Kaya ZI. Assessment of Occupational Fatigue in Healthcare Professionals During the COVID-19 Pandemia. Medical Records, 2021;3(3):232-8.
• Huang P, Liu T, Huang L, et al. Use of chest CT in combination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion. Radiology. 2020;295(1):22-23.
• Iwasawa T, Sato M, Yamaya T, et al. Ultra-high-resolution computed tomography can demonstrate alveolar collapse in novel coronavirus (COVID-19) pneumonia. Japanese Journal of Radiology. 2020;38(5):394-8.
• Disser NP, De Micheli AJ, Schonk MM, et al. Musculoskeletal consequences of COVID-19. JBJS. 2020;102(14):1197-1204.
• Paliwal VK, Garg RK, Gupta A, et al. Neuromuscular presentations in patients with COVID-19. Neurological Sciences. 2020;41(11):3039-3056.
• Ünlü S, Ilgar M, Akçiçek M. Evaluation of the Correlation Between the Severeness of Lung Involvement and Fatty Liver Disease in Covid-19. Medical Records. 2021;3(3):220-4.
• Wang Y, Dong C, Hu Y, et al. Temporal changes of CT findings in 90 patients with COVID-19 pneumonia: a longitudinal study. Radiology. 2020;296(2):E55-E64.
• Wu J, Wu X, Zeng W, et al. Chest CT findings in patients with coronavirus disease 2019 and its relationship with clinical features. Investigative Radiology. 2020;55(5):257.
• Pan F, Ye T, Sun P, et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology. 2020;295(3):715-721.
• Ji D, Zhang D, Xu J, et al. Prediction for progression risk in patients with COVID-19 pneumonia: the CALL score. Clinical Infectious Diseases. 2020;71(6):1393-9.
• Smith JA, Aliverti A, Quaranta M, et al. Chest wall dynamics during voluntary and induced cough in healthy volunteers. The Journal of Physiolog. 2012;590(3):563-574.
• Laveneziana P, Albuquerque A, Aliverti A, et al. ERS statement on respiratory muscle testing at rest and during exercise. European Respiratory Journal. 2019;53(6).
• Pereira FD, Batista WO, Fuly PDSC, et al. Physical activity and respiratory muscle strength in elderly: a systematic review. Fisioterapia em Movimento. 2014;27:129-139.
• Parshall MB, Schwartzstein RM, Adams L, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. American Journal of Respiratory and Critical Care Medicine. 2012;185(4):435-452.
• Robbie H, Wells AU, Jacob J, et al. Visual and automated CT measurements of lung volume loss in idiopathic pulmonary fibrosis. American Journal of Roentgenology. 2019;213(2):318-324.
• Albarello F, Pianura E, Di Stefano F, et al. 2019-novel coronavirus severe adult respiratory distress syndrome in two cases in Italy: an uncommon radiological presentation. International Journal of Infectious Diseases. 2020;93:192-197.