Training the breathing muscle after Covid; Study shows damage in patients but repair is possible

Medical Watch

Results from a special study are helping the medical community understand post Covid breathing difficulties.     

Covid survivors often gasp for air and complain of shortness of breath long after they recover from their initial illness. And now Shirley Ryan AbilityLab researchers say they think they know why. Covid freezes the diaphragm.

After a very long journey, on a ventilator, in a medically induced coma with Covid, Allen Washington is fighting back.

“It’s kind of like you let all the air out of your chest and someone sits on your chest and doesn’t allow you to bring any air back in,” he said. “I had lost 70 pounds. Of course my lungs, I had acute lung failure, acute kidney failure. I was paralyzed from the waist down.”

And he couldn’t breathe.

“I started walking again but I couldn’t keep my oxygen levels up,” he said. “I would start walking and at first it would drop down below 80.”

Dr. Colin Franz is a physiatrist and clinician scientist at the Shirley Ryan AbilityLab.

“That actually was the inspiration for the study, to make the connection between the weakness we saw in the legs and the arms and the problems they were having breathing,” he said.

Allen’s post-Covid complications are shared by many critical Covid survivors.

Franz set out to find out why.

“The majority of patients who came in the hospital after severe Covid – we could measure and see issues with the muscle weakness of the diaphragm muscle, which is the main breathing muscle,” he said.

Ultrasounds show what is believed to be breathing muscle damage. It is worse in Covid patients compared to other intensive care patients on a ventilator.  

“The most glaring abnormality in the people who survive Covid is that the contractility, the strength and the quality of the muscle contraction go down,” Franz said. “So you are breathing with muscles all-around your chest, trying to pull the chest open to pull a little air in. (It is) very inefficient and makes people feel short of breath.”

To ease the seemingly frozen muscle, therapists worked with patients like Allen and taught them to use their diaphragm again. 

“When you are short of breath you (gasping for air),” he said. “And when you start breathing, it allows me to continue on with my day.”

“We actually have to retrain them to breathe and that is called neuromuscular re-education,” Franz said.

The process involves taking deep breaths, holding it for 3-5 seconds and letting it out slowly.

“Almost like a meditative calming breathing,” he said.

“So like lifting weights in the gym for your arms and your legs, you can add resistance believe it or not to your breathing muscle actions,” Franz said.

Allen, a Western Michigan and Indiana MBA graduate hopes by breathing better, he’ll begin to feel like himself again. 

“By not having enough oxygen, my short-term memory is not what it used to be,” he said. “I have ringing of the ears and blurred vision. … I have tingling in my toes. I don’t have feeling in my toes, my ankles are swelling. … The biggest challenge I am having today is my memory and my balance. I’ve fallen eight times since I have been out of the hospital.”

Yet he keeps getting up. He credits his doctors and his faith.

“It takes a while. You got to have hard work to get it back,” he said.

“The good news with Covid, if you survive it, in most cases you can build back the muscle,” Franz said.

“I feel like I am a very blessed person,” Allen said.

Doctors continue to study the effects of Covid on nerves as well as other long-term side effects.

As for Allen, he moved back to his hometown of Gary, Indiana with his daughter and he’s considering running for office.

Copyright 2021 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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