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01-10-2021 | Diseases of the neuromuscular synapses and muscles | COVID-19

Subclinical myopathic changes in COVID-19

Authors: Davide Villa, Gianluca Ardolino, Linda Borellini, Filippo Cogiamanian, Maurizio Vergari, Valeria Savojardo, Flora Peyvandi, Sergio Barbieri

Published in: Neurological Sciences | Issue 10/2021

Abstract

Introduction

Coronavirus disease 2019 (COVID-19) is associated to neuromuscular symptoms in up to 10.7% of hospitalized patients. Nevertheless, the extent of muscular involvement in infected subjects with no signs of myopathy has never been assessed with neurophysiological investigations.

Methods

Over a 3-week period — from April 30 through May 20, 2020 — a total of 70 patients were hospitalized in the Internal Medicine Ward of the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico in Milan, Italy. After excluding patients who underwent invasive ventilation and steroid treatment, 12 patients were evaluated. Nerve conduction studies (NCS) included the analysis of conduction velocity, amplitude, and latency for bilateral motor tibial, ulnar nerves, and sensory sural and radial nerves. Unilateral concentric-needle electromyography (EMG) was performed evaluating at least 4 areas of 8 selected muscles. For each muscle, spontaneous activity at rest, morphology, and recruitment of motor unit action potentials (MUAPs) were evaluated.

Results

While nerve conduction studies were unremarkable, needle electromyography showed myopathic changes in 6 out of 12 subjects. All patients were asymptomatic for muscular involvement. Clinical features and laboratory findings did not show relevant differences between patients with and without myopathic changes.

Conclusion

Our data show that in SARS-CoV-2 infection muscular involvement can occur despite the absence of clinical signs or symptoms and should be considered part of the disease spectrum. The application of muscle biopsy to unravel the mechanisms of myofiber damage on tissue specimens could help to clarify the pathogenesis and the treatment response of coronavirus-mediated injury.

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Title: Subclinical myopathic changes in COVID-19
Authors: Davide Villa
Gianluca Ardolino
Linda Borellini
Filippo Cogiamanian
Maurizio Vergari
Valeria Savojardo
Flora Peyvandi
Sergio Barbieri
Publication date: 01-10-2021
Publisher: Springer International Publishing
Keywords: Diseases of the neuromuscular synapses and muscles
SARS-CoV-2
COVID-19
Myopathy
Published in: Neurological Sciences / Issue 10/2021
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-021-05469-8

At a glance: The STEP trials

Springer Medicine

Subclinical myopathic changes in COVID-19

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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