Respiratory Muscle Dysfunction and Associated Risk Factors Following COVID-19-Related Hospitalisation.

Background: Studies have highlighted long-term respiratory muscle dysfunction in COVID-19 survivors, although the underlying risk factors remain unclear. This single-centre study assessed respiratory muscle function and individual associated factors at follow-up in patients hospitalised with COVID-19 and related acute respiratory failure.

Methods: Data were collected for consecutive patients, aged ≥ 18 years, at the post-COVID outpatient service of Hospital Policlinico in Modena (Italy) in the time frame of 3 to 6 months after discharge. Data were analysed using single and multiple logistic regression models. Correlations among MIP/MEP, hand-grip values, and lung function were further explored.

Results: Out of 223 patients (mean age 67 years, 69% male) 121 (54.3%) exhibited MIP or MEP dysfunction, which was found to be associated with the use of non-invasive ventilation (aOR = 1.91 [1.07-3.49], = 0.04) and female gender (aOR = 1.76 [1.09-4.16], = 0.03) as independent risk factors. A positive correlation was observed between MIP dysfunction and hand-grip strength ( = 0.03 and 0.01), whereas both MIP and MEP were significantly associated with FEV, FVC, TLC, and DLCO.

Conclusions: Respiratory muscle dysfunction is consistently prevalent and parallels peripheral muscle weakness and the lung function level in patients at follow-up after severe COVID-19. The need for non-invasive ventilation during the acute phase and female gender might represent risk factors. MIP/MEP assessment should be recommended to observe respiratory muscle dysfunction in severe post-COVID survivors.