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Early shoulder-girdle MRI findings in severe COVID-19–related intensive care unit-acquired weakness: a prospective cohort study

OBJECTIVE: To describe clinical and early shoulder-girdle MR imaging findings in severe COVID-19–related intensive care unit-acquired weakness (ICU-AW) after ICU discharge. METHODS: A single-center prospective cohort study of all consecutive patients with COVID-19–related ICU-AW from November 2020 t...

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Detalles Bibliográficos
Autores principales: Daste, Camille, Mihoubi, Fadila, Roren, Alexandra, Dumitrache, Alina, Carlier, Nicolas, Benghanem, Sarah, Ruttimann, Aude, Mira, Jean-Paul, Pène, Frédéric, Roche, Nicolas, Seror, Paul, Nguyen, Christelle, Rannou, François, Drapé, Jean-Luc, Lefèvre-Colau, Marie-Martine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010198/
https://www.ncbi.nlm.nih.gov/pubmed/36912923
http://dx.doi.org/10.1007/s00330-023-09468-5
Descripción
Sumario:OBJECTIVE: To describe clinical and early shoulder-girdle MR imaging findings in severe COVID-19–related intensive care unit-acquired weakness (ICU-AW) after ICU discharge. METHODS: A single-center prospective cohort study of all consecutive patients with COVID-19–related ICU-AW from November 2020 to June 2021. All patients underwent similar clinical evaluations and shoulder-girdle MRI within the first month and then 3 months (± 1 month) after ICU discharge. RESULTS: We included 25 patients (14 males; mean [SD] age 62.4 [12.5]). Within the first month after ICU discharge, all patients showed severe proximal predominant bilateral muscular weakness (mean Medical Research Council total score = 46.5/60 [10.1]) associated with bilateral, peripheral muscular edema-like MRI signals of the shoulder girdle in 23/25 (92%) patients. At 3 months, 21/25 (84%) patients showed complete or quasi-complete resolution of proximal muscular weakness (mean Medical Research Council total score > 48/60) and 23/25 (92%) complete resolution of MRI signals of the shoulder girdle, but 12/20 (60%) patients experienced shoulder pain and/or shoulder dysfunction. CONCLUSIONS: Early shoulder-girdle MRI findings in COVID-19–related ICU-AW included muscular edema-like peripheral signal intensities, without fatty muscle involution or muscle necrosis, with favorable evolution at 3 months. Precocious MRI can help clinicians distinguish critical illness myopathy from alternative, more severe diagnoses and can be useful in the care of patients discharged from intensive care with ICU-AW. KEY POINTS: • We describe the clinical and shoulder-girdle MRI findings of COVID-19–related severe intensive care unit-acquired weakness. • This information can be used by clinicians to achieve a nearly specific diagnosis, distinguish alternative diagnoses, assess functional prognosis, and select the more appropriate health care rehabilitation and shoulder impairment treatment. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00330-023-09468-5.