Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents riskto develop muscle weakness associated with prolonged period of mechanical ventilationsupport and hospital stay.
Intensive care unit (ICU) acquired muscle weakness affects both respiratory and
peripheral muscles and can contribute to worsen clinical and functional outcomes. In this
way, ultrasonography muscle evaluation could help to identify early alterations guiding
the therapeutic planning and allowing to monitor the interventions performed. Therefore,
the investigators intend to follow up mechanically ventilated patients with confirmed
diagnosis of COVID-19 during ICU stay to quantify the diaphragm, parasternal intercostal,
abdominals and femoral quadriceps muscles thickness assessed by ultrasonography.
Additionally, functional capacity, frailty and level of physical activity will be
evaluated and followed for pre-admission condition and 30, 90 and 180 days after hospital
discharge .
Diagnostic Test: Muscle ultrasound evaluation
Muscle ultrasound evaluation will be performed in patients admitted with COVID-19
requiring invasive mechanical ventilation. The measurements of thickness and thickening
fraction will occur for diaphragm, abdominal - rectus abdominis, internal oblique,
external oblique and transverse abdomen - and parasternal intercostal muscles. Serial
measurements of the thickness and echogenicity of the quadriceps femoris muscle will also
be performed.
Inclusion Criteria:
- patients admitted to ICU
- having a confirmed diagnosis of COVID-19
- requiring invasive mechanical ventilation.
Exclusion Criteria:
- exclusive palliative care;
- neuromuscular diseases;
- patients who evolve with the need for lower limb amputation;
- previous known diaphragm malformations and dysfunctions;
- patients transferred from other institutions under invasive mechanical ventilation;
- clinical conditions that make the respiratory and peripheral muscle assessment
through ultrasound unfeasible.
Hospital Israelita Albert Einstein
São Paulo, Brazil
Investigator: Ricardo K Nawa, PT MSc PhD
Contact: +55 11 2151-0603
ricardo.nawa@einstein.br
Ricardo K Nawa, PT MSc PhD
+55 11 2151-0603
ricardo.nawa@einstein.br
Carla L Batista, PT
+55 11 2151-0603
carla.batista@einstein.br
Caroline G Mól, PT, Study Chair
Hospital Israelita Albert Einstein