{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T20:00:10Z","timestamp":1782849610881,"version":"3.54.5"},"reference-count":47,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Science Progress"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Ultrasonography has been commonly employed during the Coronavirus Disease 2019 (COVID-19) pandemic to assess lung and heart conditions; however, diaphragm ultrasonography (DU) has not been as widely acknowledged. This study aimed to assess the prevalence of diaphragm dysfunction (DD) in non-intubated critically ill patients with COVID-19 pneumonia on intensive care unit (ICU) admission and to examine the correlation between DD and various prognostic factors during their ICU stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective observational cohort study included 79 consecutive patients admitted to the intensive care unit (ICU) over an eight-month period. DU was performed within 24 h of admission by the same ultrasonographer. Diaphragm excursion was measured, and the diaphragmatic thickening fraction (DTF) was calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 79 patients were included in the study. Receiver operating characteristic (ROC) curve analysis identified a diaphragmatic thickening fraction (DTF) threshold of \u226425% for predicting ICU mortality (area under the curve [AUC] 0.87, sensitivity 85.1%, specificity 71.9%). Based on this cutoff, diaphragmatic dysfunction (DD) was present in 50.6% of patients on ICU admission and was associated with higher mortality (65.0% vs. 15.4%, p&lt;0.001), fewer ICU-free days, and higher intubation rates. Survivors had significantly higher DTF values than non-survivors (30.7% vs. 18.8%, p&lt;0.001). Multivariate analyses showed that DD on ICU admission was an independent predictor of mortality (HR 3.6, 95% CI 1.2\u201310.5, p=0.02), along with ferritin levels and the presence of septic shock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DD was common at ICU admission and was associated with higher intubation rates, fewer ICU-free days, and increased mortality. Early assessment of diaphragm function may help guide clinical management in non-intubated critically ill COVID-19 patients with acute respiratory failure, and a lower diaphragmatic thickening fraction may serve as a potential predictor of poor outcomes in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00368504261447364","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T12:05:27Z","timestamp":1778760327000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing diaphragm dysfunction in ICU patients with COVID-19 pneumonia: A prospective observational cohort study"],"prefix":"10.1177","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4121-1931","authenticated-orcid":false,"given":"Nazire","family":"Ates Ayhan","sequence":"first","affiliation":[{"name":"\u00c7ukurova University Faculty of 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