Patient characteristics, treatments, imaging findings, and pulmonary function and muscle function test results of those undergoing diaphragm ultrasound examination to investigate new hemidiaphragm elevation post COVID-19 pneumonia
| Patient | Sex | BMI | MRC Dyspnoea Scale and orthopnoea (Y/N) | Smoking status (current/ex/never) | Significant comorbidities | Level of care | Dex (Y/N %) | Length of hospital stay (days) | Number of days between COVID-19 PCR detection and latest CXR | Number of days between COVID-19 PCR detection and US | Degree of hemidiaphragm elevation on CXR (mm) | US findings and DTf (%) | FEV1pp, FVCpp, ratio, DLCOpp and KCOpp | Fall in VC from erect to supine | PImax cmH2O (%) | SNIP cmH2O (%) |
| Summary data | 46:54 (F:M) (%) | 33±5 | 2±1.3, 25:75 | 8/75/17 (%) | – | – | 33:67 | 18±24 | 181±111 | 246±101 | 53±24 | DTf (%) 28±20 | 93±38 105±34 78±12 59±22 80±16 | −14±15 | 61±31 (84±50) | 41±17 (45±17) |
| 1 | M | 35 | 4, Y | Current | COPD, HTN | HDU, CPAP | Y | 9 | 93 | 99 | 70 | Normal excursion. DTf not assessed. | 62 91 53 39 61 | −4 | – | – |
| 2*† | F | 34 | 1, N | Ex | Nil | IMV | N | 18 | 332 | 332 | 50 | <10 mm excursion, right. DTf not assessed due to adiposity. | 106 116 77 66 75 | −10 | 22 (40) | 30 (37) |
| 3*†‡ | M | 25 | 4, Y | Ex | Nil | IMV | Y | 93 | 88 | 207 | 115 | <10 mm excursion, right. Left DTf: 126%, right DTf: 18%. | 27 54 85 30 78 | −21 | 49 (55) | 47(46) |
| 4 | M | 35 | 1, N | Never | HTN | HDU, CPAP | N | 10 | 221 | 351 | 45 | Normal excursion. DTf not assessed due to adiposity. | 115 113 81 83 101 | −3 | 81 (91) | 74 (73) |
| 5*† | F | 30 | 2, N | Ex | Depression, PTSD | IMV | N | 13 | 353 | 386 | 40 | <10 mm excursion, right. Left DTf: 68%, right DTf: 7%. | 103 109 81 Unable to perform DLCO/KCO. | −52 | 108 (178) | 37 (44) |
| 6 | M | 39 | 1, N | Ex | OSAS | HDU | N | 7 | 257 | 390 | 32 | Normal excursion. Unable to assess DTf due to adiposity. | 96 104 71 91 112 | –7 | – | – |
| 7*‡ | M | 29 | 3, Y | Never | Asthma, psoriasis | Home | N | 0 | 58 | 135 | 56 | <10 mm excursion, right. Unable to assess DTf due to adiposity. | 38 38 79 25 77 | −17 | 72 (58) | 16 (14) |
| 8*‡ | M | 27 | 1, N | Ex | Psoriasis | HDU, HFNO | Y | 20 | 7 | 156 | 46 | <10 mm excursion, right. DTf not assessed. | – | – | – | – |
| 9* | F | 35 | 0, N | Ex | Nil | HDU, CPAP | Y | 7 | 95 | 168 | 43 | <10 mm excursion, right. Left DTf: 100%, right DTf: 26%. | 124 147 72 57 67 | −6 | 80 (138) | 50 (61) |
| 10*†‡ | F | 32 | 1, N | Ex | Nil | IMV | N | 32 | 323 | 343 | 50 | <10 mm excursion, right. Unable to assess DTf due to adiposity. | 130 138 80 66 68 | −4 | – | – |
| 11 | F | 38 | 0, N | Ex | HTN | Home | N | 0 | 177 | 199 | 76 | Normal excursion. Unable to assess DTf due to adiposity. | – | – | – | – |
| 12*† | F | 41 | 3, N | Ex | Obesity, HTN, asthma, T2DM | Ward | N | 12 | 175 | 195 | 33 | <10 mm excursion, left. Left DTf: 62%, right DTf: 63%. | 135 141 103 74 83 | 0 | 17 (33) | 34 (43) |
Summary data reported in mean±SD or percentage, as appropriate.
*Patients with poor or paradoxical movements on diaphragm ultrasound.
†Patients who underwent neurophysiology studies (see text for detailed results).
‡Patients with fibrotic changes seen on CT thorax imaging.
BMI, body mass index; COPD, Chronic Obstructive Pulmonary Disease; CXR, chest X-ray; Dex, dexamethasone; DLCOpp, diffusing capacity of the lungs for carbon monoxide, percentage predicted; DTf, diaphragm thickening fraction; F, female; FEV1pp, FEV1 percentage predicted; FVCpp, FVC percentage predicted; HDU, high dependency unit; HFNO, high-flow nasal oxygen; HTN, hypertension; IMV, invasive mechanical ventilation; KCOpp, carbon monoxide transfer coefficient, percentage predicted; M, male; MRC, Medical Research Council; N, no; OSAS, obstructive sleep apnoea syndrome; PImax, maximal inspiratory pressure; PTSD, post-traumatic stress disorder; SNIP, sniff nasal inspiratory pressure; T2DM, Type Two Diabetes Mellitus; US, ultrasound; VC, vital capacity; Y, yes.