Elsevier

Journal of Clinical Neuroscience

Volume 79, September 2020, Pages 241-245
Journal of Clinical Neuroscience

Review article
Approach to critical illness myopathy and polyneuropathy in the older SARS-CoV-2 patients

https://doi.org/10.1016/j.jocn.2020.07.058Get rights and content

Highlights

  • Critical illness myopathy/neuropathy often go under-diagnosed.

  • Over 70% of patients hospitalized for SARS-CoV-2 were ≥50 years old.

  • Older populations are at higher risk of suffering from ICU acquired weakness.

  • Early mobilization is a mainstay of treatment for ICU acquired weakness.

Abstract

One of the major concerns of the health care community and the public surrounding the SARS-CoV-2 pandemic is the availability and use of ventilators. Unprecedented surges of patients presented to intensive care units across the country, with older adults making up a large proportion of the patient population. This paper illustrates contemporary approaches to critical illness myopathy (CIM), critical illness polyneuropathy (CIP), and critical illness polyneuromyopathy (CIPNM) in older patients, including incidence, risk factors, mechanisms for pathology, diagnosis, contemporary treatment approaches, and outcomes. We hope that the following analysis may help educate clinicians and ultimately decrease the duration of the mechanical ventilation required by these patients, resulting in improved clinical outcomes and an increase in ventilator availability for other patients in need.

Abbreviations

CIM
critical illness myopathy
CIP
critical illness polyneuropathy
CIPNM
critical illness polyneuromyopathy
PCIS
post intensive care syndrome
ANM
acute necrotizing myopathy
(IL-6)
interleukin-6
SAA1
serum amyloid A1
ICUAW
ICU-acquired weakness
ARDS
acute respiratory distress syndrome

Keywords

SARS-CoV-2
COVID-19
Critical illness myopathy
Critical illness polyneuropathy
Intensive care unit-acquired weakness
Older adults

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