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患有新冠后状况且肌电图检查结果呈肌病性改变的非住院患者,与无肌病性检查结果的患者相比,在症状严重程度和临床表现方面并无差异。

Non-Hospitalized Patients With Post-COVID Condition and Myopathic Electromyography Findings Show no Difference in Symptom Severity and Clinical Manifestations Compared to Those Without Myopathic Findings.

作者信息

Sepic Atif, Tryfonos Andrea, Rundqvist Helene, Lundberg Tommy R, Gustafsson Thomas, Pourhamidi Kaveh

机构信息

Unit of Clinical Neurophysiology, Karolinska University Hospital, Stockholm, Sweden.

Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, Stockholm, Sweden.

出版信息

Muscle Nerve. 2025 Feb;71(2):223-228. doi: 10.1002/mus.28319. Epub 2024 Dec 13.

Abstract

INTRODUCTION

The COVID-19 pandemic has resulted in a post-infectious syndrome designated as long-COVID or post-COVID condition (PCC) that presents with numerous symptoms including fatigue and myalgias. This study evaluated myopathic electromyography (EMG) findings in non-hospitalized PCC patients in relation to symptom severity, quality of life (QoL), and physical function.

METHODS

Twenty-nine PCC patients with persistent symptoms ≥ 3 months after laboratory-confirmed SARS-CoV-2 infection, without hospitalization or comorbidities, were included. EMG, nerve conduction studies (NCS), and quantitative sensory testing (QST) were performed. Symptom severity was measured with visual analog scales, QoL with validated questionnaires, and physical function with the 6-min walk test, cardiopulmonary exercise testing, handgrip strength, and isokinetic dynamometry.

RESULTS

Myopathic findings on EMG were present in 62% of PCC patients (n = 18). Symptom severity (muscle pain and fatigue) and QoL (physical function and fatigue) were similar between patients with and without myopathic EMG findings. The 6-min walk test (457 ± 81 vs. 459 ± 86 m) and peak VO (29 ± 9 vs. 28 ± 6 mL/kg/min) were similar between patients with and without myopathic EMG findings. Handgrip strength (32 [29-43] vs. 33 [29-50] kg) and quadriceps muscle strength (136 [111-191] vs. 136 [114-184] Nm) were comparable between the groups. NCS and QST results were normal in all patients.

DISCUSSION

Myopathic findings on EMG are common in PCC patients, but no significant differences in symptom severity, QoL, or physical function were found between those with and without myopathic EMG findings. Myopathic EMG changes in PCC patients should be interpreted with caution, considering the overall clinical context.

摘要

引言

新冠疫情导致了一种感染后综合征,被称为长期新冠或新冠后状况(PCC),其表现出包括疲劳和肌痛在内的众多症状。本研究评估了非住院PCC患者的肌病性肌电图(EMG)结果与症状严重程度、生活质量(QoL)和身体功能之间的关系。

方法

纳入29例实验室确诊感染SARS-CoV-2后持续症状≥3个月、未住院且无合并症的PCC患者。进行了肌电图、神经传导研究(NCS)和定量感觉测试(QST)。用视觉模拟量表测量症状严重程度,用经过验证的问卷测量生活质量,用6分钟步行试验、心肺运动试验、握力和等速肌力测试测量身体功能。

结果

62%的PCC患者(n = 18)存在肌电图的肌病性表现。有和没有肌电图肌病性表现的患者在症状严重程度(肌肉疼痛和疲劳)和生活质量(身体功能和疲劳)方面相似。有和没有肌电图肌病性表现的患者在6分钟步行试验(457±81 vs. 459±86米)和峰值摄氧量(29±9 vs. 28±6毫升/千克/分钟)方面相似。两组之间的握力(32[29 - 43] vs. 33[29 - 50]千克)和股四头肌力量(136[111 - 191] vs. 136[114 - 184]牛米)相当。所有患者的神经传导研究和定量感觉测试结果均正常。

讨论

肌电图的肌病性表现在PCC患者中很常见,但有和没有肌电图肌病性表现的患者在症状严重程度、生活质量或身体功能方面未发现显著差异。考虑到整体临床情况,对PCC患者的肌电图肌病性改变应谨慎解读。

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