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Skeletal muscles of patients infected with SARS-CoV-2 develop severe myofiber damage upon one week of admission on the intensive care unit
Stevens, Sjoerd Hendrickx, Paul Snijders, Tim Lambrichts, Ivo Stessel, Björn Dubois, Jasperina van Loon, Lucas J. C. Vandenabeele, Frank Agten, Anouk
Stevens, Sjoerd
Hendrickx, Paul
Snijders, Tim
Lambrichts, Ivo
Stessel, Björn
Dubois, Jasperina
van Loon, Lucas J. C.
Vandenabeele, Frank
Agten, Anouk
Abstract
Many critically ill patients infected with SARS-CoV-2 have been submitted to an intensive care unit (ICU). Patients with a SARS-CoV-2 infection that survive critical illness are confronted with months of physical impairments. To maximize recovery, it is important to understand the musculoskeletal involvement in critically ill patients infected with SARS-CoV-2. The aim of the present study was to assess the myocellular changes in SARS-CoV-2 patients that occur throughout the first week of ICU admission. In n = 22 critically ill patients infected with SARS-CoV-2, a biopsy sample from the vastus lateralis muscle was obtained at day 1–3 and day 5–8 following ICU admission. Fluorescence microscopy was used to assess type I and type II muscle fiber size and distribution, myonuclear content, and muscle tissue capillarization. Transmission electron microscopy was used to support quantitative data at an ultrastructural level. Changes in type I and type II muscle fiber size showed large inter-individual variation. The average change in type I fiber size was +309 ± 1834 µm2, ranging from −2129 µm2 (−31%) to +3375 µm2 (+73%). The average change in type II fiber size was −224 ± 1256 µm2, ranging from −1410 µm2 (−36%) to +2592 µm2 (+48%). Ultrastructural observations showed myofibrillar and hydropic degeneration, and fiber necrosis. This study shows that ICU patients admitted with SARS-CoV-2 suffer from substantial muscle fiber damage during ICU admission. These results are a call for action towards more specialized rehabilitation programs for patients admitted to the ICU with SARS-CoV-2 infection.
Keywords
severe acute respiratory syndrome virus, skeletal muscles, sepsis, respiratory distress syndrome, critical illness
Date
2022
Type
Journal article
Journal
Applied Sciences
Book
Volume
12
Issue
14
Page Range
1-18
Article Number
Article 7310
ACU Department
Centre for Exercise and Nutrition
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY 4.0
File Access
Open