Incidence of Myopathy and Neuropathy in Patients with COVID-19 Admitted to the Intensive Care Unit During the Extubation Phas

Abstract

Critical myopathy and neuropathy have a high prevalence in the intensive care unit and are observed in patients who are hospitalized in the intensive care unit for more than a week. Also, patients with corona virus hospitalized in the intensive care unit mostly have multi-organ involvement and are under care for a long time, and during the care period, neuromuscular relaxants are widely used for them to tolerate the ventilator; The sum of these factors can be effective in the occurrence of myopathy and critical neuropathy in patients with corona virus admitted to the intensive care unit, and suffering from these complications can increase the mortality rate in these patients who receive the relevant treatments and in terms of Corona disease have recovery, increase; Therefore, it seems necessary to determine the incidence of critical myopathy and neuropathy in patients admitted to the intensive care unit during the extubation phase, so that diagnostic and therapeutic measures can be considered for them in case of high incidence of these complications. Materials and Methods: Patients who are candidates for extubation were included in this study. For none of the patients, one hour before the test, no drug that interferes with neuromuscular transmission was administered; Patients were evaluated and tested by a neurologist. Bilateral examination of median, ulnar, deep peroneal motor nerves (from the extensor digitorum brevis muscle), EDB and tibia (abductor hallucis brevis AH) (compound motor potentials, CMAPs) and median, ulnar, radial and sural sensory nerves (action potentials) became. Abductor digitorum minor (ADM) muscle responses to 3 Hz repetitive stimulation of the ulnar nerve were performed to exclude patients with neuromuscular transmission disease. The number of insertions was twice for each muscle and the resting activity was evaluated for 60 times. Results: A total of 111 patients with covid-19 in the extubation stage were included in this study and it was found that the frequency of myopathy and neuropathy in this study is 9.8%. A significantly higher rate of sensory-motor demyelinating polyneuropathy and axonal polyneuropathy was shown among the group with polyneuropathy/myopathy compared to the non-affected group.