Respiratory muscle strength in patients after COVID-19

Savushkina OI1,2, Malashenko MM2, Cherniak AV1, Krjukov EV2, Sinitsyn EA1, Zykov KA1
About authors

1 Pulmonology Scientific Research Institute under Federal Medical Biological Agency, Moscow, Russia

2 Main Military Clinical Hospital named after academician N. N., Ministry of Defense, Moscow, Russia

Correspondence should be addressed: Olga I. Savushkina
Orekhovy bulvar, 28, Moscow, 115682; ur.xednay@anikhsuvas-aglo

About paper

Funding: ordered by the state under the research topic "Impact of the new coronavirus infection SARS-CoV-2 on the functional parameters of respiratory system during the convalescence period" (code: "Post-COVID functional diagnostics").

Acknowlegements: we would like to thank Zaitov M. R., engineer of ZAO Meditsinskioye Sistemy, for technical support.

Author contribution: Savushkina OI — study design development, clinical material collection, analysis and interpretation of the results, article authoring; Malashenko MM — clinical material collection, interpretation of the results; Chernyak AV — study design development, clinical material collection, analysis and interpretation of the results, article editing; Kryukov EV — article concept development, editing; Sinitsyn EA — interpretation of the results, article editing; Zykov KA — article editing, approval of the final version of the manuscript.

Compliance with ethical standards: the study was approved by the Ethics Committee of the Pulmonology Scientific Research Institute of the FMBA of Russia (minutes № 01-21 of May 14, 2021). All study participants signed informed consent.

Received: 2021-07-19 Accepted: 2021-08-09 Published online: 2021-09-16

Respiratory muscles (RM) are a very important part of the respiratory system that enables pulmonary ventilation. This study aimed to assess the post-COVID-19 strength of RM by estimating maximum static inspiratory (MIP or PImax) and expiratory (MEP or PEmax) pressures and to identify the relationship between MIP and MEP and the parameters of lung function. We analyzed the data of 36 patients (72% male; median age 47 years) who underwent spirometry, and body plethysmography, diffusion test for carbon monoxide (DLCO) and measurement of MIP and MEF. The median time between the examinations and onset of COVID-19 was 142 days. The patients were divided into two subgroups. In subgroup 1, as registered with computed tomography, the median of the maximum lung tissue damage volume in the acute period was 27%, in subgroup 2 it reached 76%. The most common functional impairment was decreased DLCO, detected in 20 (55%) patients. Decreased MIP and MEP were observed in 5 and 11 patients, respectively. The subgroups did not differ significantly in MIP and MEP values, but decreased MIP was registered in the second subgroup more often (18%). There were identified no significant dependencies between MIP/MEP and the parameters of ventilation and pulmonary gas exchange. Thus, in patients after COVID-19, MIP and MEP were reduced in 14 and 31% of cases, respectively. It is reasonable to add RM tests to the COVID-19 patient examination plan in order to check them for dysfunction and carry out medical rehabilitation.

Keywords: respiratory muscle strength, spirometry, body plethysmography, diffusion test, post-COVID-19, new coronavirus infection