Department of Pulmonary Diseases, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.
Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.
Nutrients. 2022 Oct 15;14(20):4319. doi: 10.3390/nu14204319.
Muscle weakness is a prominent symptom in post-acute sequelae of COVID-19 (PASC). However, few studies have objectively and longitudinally assessed muscle strength after varying COVID-19 severity grades. This observational study aimed to explore the prevalence, determinants, and 1.5 years change of quadriceps muscle weakness in 98 patients discharged from COVID-19 hospitalization and in 50 patients with PASC following mild COVID-19. Isometric quadriceps maximal voluntary contraction (MVC) was assessed on a computerized dynamometer at three visits. Also, in a subgroup of 14 post-COVID-19 patients with quadriceps muscle weakness, muscle thickness and echo intensity were determined by muscle ultrasound of nine upper and lower extremity muscles. Muscle weakness was found in 59% of post-hospitalized patients and in 65% of those with PASC following mild COVID-19 at ~14 weeks after acute COVID-19. Whereas during ~1.5 years follow-up MVC modestly improved, muscle weakness prevalence remained unchanged. Hospital length of stay and diabetes mellitus were identified as possible predictors of muscle weakness following COVID-19 hospitalization. No predictors could be identified in those with PASC following mild COVID-19. Ultrasound outcomes revealed no large structural abnormalities. In conclusion, clinically relevant muscle weakness is common after COVID-19 and its long-term improvement is poor. Future studies with relevant control groups are warranted to confirm our data.
肌肉无力是 COVID-19 后急性后遗症（PASC）的一个突出症状。然而，很少有研究客观和纵向评估不同 COVID-19 严重程度等级后的肌肉力量。这项观察性研究旨在探讨 98 名从 COVID-19 住院中出院的患者和 50 名轻度 COVID-19 后出现 PASC 的患者中股四头肌无力的患病率、决定因素和 1.5 年变化。在三次就诊时，使用计算机测力计评估等长股四头肌最大自主收缩（MVC）。此外，在 14 名 COVID-19 后股四头肌无力的患者亚组中，通过九种上下肢肌肉的肌肉超声确定肌肉厚度和回波强度。在急性 COVID-19 后约 14 周时，住院后的患者中有 59%和轻度 COVID-19 后出现 PASC 的患者中有 65%出现肌肉无力。虽然在约 1.5 年的随访中 MVC 略有改善，但肌肉无力的患病率保持不变。住院时间和糖尿病被确定为 COVID-19 住院后肌肉无力的可能预测因素。在轻度 COVID-19 后出现 PASC 的患者中，无法确定预测因素。超声结果显示没有明显的结构异常。总之，COVID-19 后出现明显的肌肉无力且其长期改善情况较差。需要进行有相关对照组的未来研究来证实我们的数据。
