COVID'S IMPACT ON THE BODY.
>> PARIS, AMONG THE MOST COMMON
LONG-TERM PROBLEMS FOR SURVIVORS
OF SEVERE COVID-19 IS A
PERSISTENT SHORTNESS OF BREATH
AND FATIGUE.
YOU MIGHT THINK THAT IS BECAUSE
OF LUNG DAMAGE DUE TO THE
CORONAVIRUS AND THAT DOES OCCUR.
BUT A STUDY FOUND THAT DAMAGE TO
THE DIAPHRAGM COULD ALSO BE A
CAUSE OF THOSE LONG-TERM
SYMPTOMS.
JOINING US TO TALK ABOUT THAT
STUDY IS Dr. COLIN FRANZ A
PHYSICIAN SCIENTIST AND
PROFESSOR AT NORTHWESTERN
UNIVERSITY'S FEINBERG SCHOOL OF
MEDICINE.
THANK YOU FOR JOINING US.
YOU'VE DONE A STUDY ON PATIENTS
WHO HAVE LONG-TERM EFFECTS FROM
HAVING BEEN HOSPITALIZED WITH
COVID-19 SOME OF THE SYMPTOMS
INCLUDE SHORTNESS OF BREATH AND
FATIGUE, POOR SLEEP AND
HEADACHES, FEELING LIGHT-HEADED
AND A TINGLING PAIN.
MOST FOLKS MIGHT THINK THIS IS
AN ISSUE WITH THE LUNGS BUT YOUR
STUDY FOCUSES ON THE DIAPHRAGM.
WHAT LED YOU TO FOCUS ON THAT
AND REMIND US WHAT THE DIAPHRAGM
DOES.
>> THE DIAPHRAGM IS THE MAIN
BREATHING MUSCLE AND WHEN YOU
BREATHE IN IT CONTRACTS AND IT
GOES DOWN AND PULLS AIR INTO THE
CHEST.
AND THE MUSCLE CAN BE WEAKENED
IN A NUMBER OF DIFFERENT
SITUATIONS WHICH I ALSO TAKE
CARE OF BUT WE RELATED TO COVID
IS ALL THE WEAKNESS WE WERE
SEEING IN MUSCLES IN INDIVIDUALS
THAT WENT TO THE INTENSIVE CARE
UNIT AND CAME TO THE
REHABILITATION HOSPITAL AND THEY
ARE WEAK ALL OVER.
SO IT STOOD TO REASON THAT SOME
OF THE BREATHING PROBLEMS MIGHT
BE FROM THE BREATHING MUSCLE
BEING WEAKENED.
>> AND WHAT DID YOUR STUDY FIND?
>> HIM.
IT'S HARD TO DIRECTLY RELATE THE
MUSCLE.
BUT USING ULTRASOUND WHICH A LOT
OF PEOPLE GET FAMILIAR WITH WHEN
THEY HAVE CHILDREN AND FOR OTHER
TESTS IT IS A NONINVASIVE TEST
WE CAN DO WE WERE ABLE TO LOOK
AT THE THICKNESS OF THE MUSCLE
AND HOW WELL IT WAS CONTRACTING.
AND WHAT WE FOUND VERY OFTEN IN
COVID PATIENTS FOR SURVIVORS
WITH SEVERE COVID-19 WAS
WEAKENED POOR QUALITY MUSCLE
THAT DID NOT CONTRACT WELL.
>> IS THIS DAMAGE TO THE
DIAPHRAGM IS THIS UNIQUE TO
COVID PATIENTS OR DO OTHER
PATIENTS WHO HAVE HAD EXTENDED
STAYS IN THE ICU HAVE THEY HAD
SIMILAR ISSUES?
>> THIS WAS A QUESTIONABLY
STARTED TO GET THIS DATA AND
THAT QUESTION CAME UP
IMMEDIATELY.
AND WE KNOW THAT PEOPLE AFTER
BEING IN THE INTENSIVE CARE UNIT
DO GET WEAK.
BUT WE FELT THIS WEAKNESS THAT
THE COVID SURVIVORS HAD WAS OUT
OF PROPORTION TO WHAT WE ARE
USED TO AT THE REHABILITATION
LEVEL.
WHEN WE COMPARED THEM TO A GROUP
OF PEOPLE WE TRIED TO MATCH FOR
INTENSIVE CARE UNIT STAYS WE
FOUND THAT THE COVID PATIENTS
HAD MORE SEVERE MUSCLE WEAKNESS
HAD A HIGHER RATE THAN PEOPLE
WHO SURVIVED THE ICU FOR OTHER
ILLNESSES.
>> IS THIS DAMAGE IS IT
PERMANENT OR SOMETHING THAT CAN
BE REMEDIED WITH MEDICATION OR
THERAPY?
>> THERE IS A SILVER LINING TO
THIS OBSERVATION IT'S THAT
ALTHOUGH IT'S NOT IN THE
PUBLISHED REPORT YET IN THE NEWS
DATA WHERE WE'VE BEEN TRACKING
PEOPLE AFTER THEY LEAVE THE
REHAB HOSPITAL IS THAT THE VAST
MAJORITY OF PEOPLE ARE GETTING
BETTER AND WE HAVE SEEN THAT
THEY DO RESPOND THIS WEAKNESS
DOES RESPOND TO REHABILITATION.
AND TO TRAINING OF THE DIAPHRAGM
MUSCLE.
>> WHAT WOULD YOU SAY ARE THE
MOST EFFECTIVE WAYS TO HELP
PATIENTS RECOVER?
WHAT DOES THAT TRAINING INVOLVE?
>> THERE IS A COUPLE ASPECTS.
THE FIRST PART IS, I THINK THE
ANALOGY IF SOMEONE HAS A KNEE
INJURY AND STARTS LIMPING AND
THAT KNEE INJURY HEALS AND THEY
CONTINUE TO LIMP.
WE'VE SEEN THAT TAKE PLACE WITH
THE DIAPHRAGM WHERE PEOPLE START
BREATHING THE ACCESSORY MUSCLES
THAT CAN MOVE THE CHEST.
AND THEN WHAT WE NEED TO DO IS
TRAIN THEM TO START BREATHING
AGAIN WITH THE DIAPHRAGM WHICH
IS AS IT STARTS TO WORK AGAIN
THEY NEED TO START TO RECOGNIZE
THEY CAN ACTIVATE IT.
AND THERE'S BUILDING BACK THE
MUSCLE STRENGTH AND ENDURANCE WE
DO THROUGH TARGETED EXERCISES
THAT ACTIVATE RESISTANCE
WEIGHTLIFTING FOR THE DIAPHRAGM.
>> AS THE DELTA VARIANT SPREADS
WE KNOW THIS PANDEMIC IS FAR
FROM OVER, AND THERE WILL BE
MORE PEOPLE RECOVERING FROM SORT
OF LONG-TERM COVID SYMPTOMS ARE
THE INSURANCE COMPANIES WILLING
TO COVER THE COSTS OF THIS
REHABILITATION?
>> WELL, I THINK THERE'S ALL THE
ISSUES WITH ACCESS TO CARE
BEFORE COVID.
THE BIGGEST THING WE'VE DONE ON
OUR SIDE OF THINGS THAT THE
SHIRLEY LAB AND NORTHWESTERN AND
OTHER HOSPITAL SYSTEMS ACROSS
THE CITY AND THE COUNTRY, IS TRY
TO BUILD A COMPREHENSIVE POST
COVID CLINIC WHICH IDEALLY WORKS
TOGETHER SO YOU CAN SEE THE
SPECIALISTS YOU NEED FOR THE
WAYS THIS CAN AFFECT MANY PARTS
OF THE BODY AND MAKE IT EASIER
TO NAVIGATE THE SYSTEM.
ONE OF THE HARDEST THINGS IS YOU
HAVE A MULTITUDE OF SYMPTOMS AND
YOU DON'T KNOW WHERE TO START
GETTING HELP.
>> AND YOU JUST MENTIONED
PROBABLY SOME SORT OF MORE
COMPREHENSIVE CLINIC THIS STUDY
WAS DONE ON A SMALL GROUP OF
PATIENTS.
WHERE DOES THE RESEARCH GO FROM
HERE?
>> THE LIFETIME BETWEEN RESEARCH
BEING PUBLISHED AND WHAT WE ARE
DOING.
WE SCANNED MORE THAN DOUBLED THE
NUMBER OF PATIENTS NOW AND I'VE
EXPANDED TO STUDY PEOPLE WHO
WERE QUOTE-UNQUOTE LONG-HAULERS
THE PEOPLE WHO HAD COVID BUT
WERE NOT SO SICK THEY NEEDED TO
GO TO THE HOSPITAL OR THE
INTENSIVE CARE UNIT.
THIS WORK IN TERMS OF
UNDERSTANDING WHAT IMPACTS
QUOTE-UNQUOTE MILDER COVID MAY
HAVE ON PEOPLE AND THEIR
BREATHING.
BECAUSE SHORTNESS OF BREATH AND
SHORTNESS OF BREATH WITH
EXERTION LIKE DAILY ACTIVITIES
OR EXERCISE IS A VERY COMMON
AFTER EFFECT OF COVID AND LONG
COVID IN PATIENTS WHO EVEN IF
THEY WERE NOT SEVERELY ILL.
AND DO PEOPLE GET BETTER AND
RESPOND TO OUR TREATMENTS?
WHICH KIND OF IS ONE OF THE
STRUGGLES IS WE'RE TRYING TO
FIGURE IT OUT AS WE GO ALONG AND
INCORPORATE ALL THE NEW DATA ON
COVID BUT WE ARE FINDING SOME
GOOD REASON TO CONTINUE WITH THE
EXERCISES BECAUSE WE'RE SEEING
MANY OF OUR PATIENTS ARE GETTING
BETTER.
THE MAJORITY DO AAFTER SEVERE