Early shoulder-girdle MRI findings in severe COVID-19–related intensive care unit-acquired weakness: a prospective cohort study.
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| Title: | Early shoulder-girdle MRI findings in severe COVID-19–related intensive care unit-acquired weakness: a prospective cohort study. |
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| Authors: | Daste, Camille1,2,3 (AUTHOR), Mihoubi, Fadila3,4 (AUTHOR), Roren, Alexandra2,3 (AUTHOR), Dumitrache, Alina5 (AUTHOR), Carlier, Nicolas6 (AUTHOR), Benghanem, Sarah1,7,8 (AUTHOR), Ruttimann, Aude7 (AUTHOR), Mira, Jean-Paul1,7 (AUTHOR), Pène, Frédéric1,7,9 (AUTHOR), Roche, Nicolas1,6 (AUTHOR), Seror, Paul10 (AUTHOR), Nguyen, Christelle1,2,11 (AUTHOR), Rannou, François1,2,11 (AUTHOR), Drapé, Jean-Luc1,3,4 (AUTHOR), Lefèvre-Colau, Marie-Martine1,2,3 (AUTHOR) marie-martine.lefevre-colau@aphp.fr |
| Source: | European Radiology. Jul2023, Vol. 33 Issue 7, p4994-5006. 13p. 5 Black and White Photographs, 1 Diagram, 4 Charts. |
| Subjects: | Medical Research Council (Great Britain), Critical care medicine, Magnetic resonance imaging, Shoulder girdle, Cohort analysis, Longitudinal method |
| Abstract: | 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. [ABSTRACT FROM AUTHOR] |
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| Database: | Engineering Source |
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| Abstract: | 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. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 09387994 |
| DOI: | 10.1007/s00330-023-09468-5 |
