Diaphragmatic morphological post-mortem findings in critically ill COVID-19 patients: an observational study.

IF 0.8 Q4 RESPIRATORY SYSTEM
Monaldi Archives for Chest Disease Pub Date : 2025-07-21 Epub Date: 2024-04-23 DOI:10.4081/monaldi.2024.2829
Luigi Vetrugno, Cristian Deana, Savino Spadaro, Gianmaria Cammarota, Domenico Luca Grieco, Annarita Tullio, Tiziana Bove, Carla Di Loreto, Salvatore Maurizio Maggiore, Maria Orsaria, Diasus Study Group
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引用次数: 0

Abstract

Our study investigates the post-mortem findings of the diaphragm's muscular structural changes in mechanically ventilated COVID-19 patients. Diaphragm samples of the right side from 42 critically ill COVID-19 patients were analyzed and correlated with the type and length of mechanical ventilation (MV), ventilatory parameters, prone positioning, and use of sedative drugs. The mean number of fibers was 550±626. The cross-sectional area was 4120±3280 μm2, while the muscular fraction was 0.607±0.126. The overall population was clustered into two distinct populations (clusters 1 and 2). Cluster 1 showed a lower percentage of slow myosin fiber and higher fast fiber content than cluster 2 (68% vs. 82%, p<0.00001, and 29.8% vs. 18.8%, p=0.00045, respectively). The median duration of MV was 180 (41-346) hours. In cluster 1, a relationship between assisted ventilation and fast myosin fiber percentage (R2=-0.355, p=0.014) was found. In cluster 2, fast fiber content increased with increasing length of the controlled MV (R2=0.446, p=0.006). A high grade of fibrosis was reported. Cluster 1 was characterized by fibers' atrophy and cluster 2 by hypertrophy, supposing different effects of ventilation on the diaphragm but without excluding a possible direct viral effect on diaphragmatic fibers.

COVID-19 重症患者膈肌形态学尸检结果:一项观察性研究。
我们的研究调查了机械通气的 COVID-19 患者死后膈肌的肌肉结构变化。我们对 42 名 COVID-19 重症患者的右侧膈肌样本进行了分析,并将其与机械通气(MV)的类型和时间、通气参数、俯卧位和镇静药物的使用相关联。纤维的平均数量为 550±626。横截面积为 4120±3280 μm2,肌肉分数为 0.607±0.126。整个群体被分为两个不同的群组(群组 1 和群组 2)。与第 2 组相比,第 1 组的慢肌球蛋白纤维比例较低,而快肌球蛋白纤维含量较高,分别为 68% 和 82%(p<0.05)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.60
自引率
0.00%
发文量
1
审稿时长
12 weeks
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