Article Text
Abstract
This study characterised the hemidiaphragm elevation on 3-month interval chest X-rays (CXRs) of patients post COVID-19 pneumonia. 467 CXRs were screened; 19 (4.1%) had an elevated hemidiaphragm. There were 15 (3.2%) patients of interest with new hemidiaphragm elevation, persisting on average 7 months post COVID-19 diagnosis. Symptomatic patients underwent diaphragm ultrasound (n=12), pulmonary function test (n=10), muscle function test (n=6) and neurophysiology (n=5), investigating phrenic nerve function. Ultrasound demonstrated reduced/paradoxical diaphragmatic movements in eight; four of eight had reduced thickening fraction. Neurophysiology peripheral limb studies did not support the differential diagnoses of critical illness neuropathy/myopathy. We propose that, in selected patients, COVID-19 may cause phrenic nerve mononeuritis.
- COVID-19
- Respiratory Muscles
- Imaging/CT MRI etc
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Footnotes
Contributors Conception and design: SML, BC-K. Data collection: SML, KS, AA, AKM, AM, BC-K. Analysis and interpretation of data: SML, BC-K. Drafting of the article: SML. Critical revision of the article for important intellectual content: SML, AKM, GR, BC-K. Final approval of the article: SML, KS, AA, AM, AKM, GR, BC-K. Provision of study materials or patients: KS, GR, BC-K.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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