{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:13:13Z","timestamp":1792696393465,"version":"4.5.0"},"reference-count":162,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T00:00:00Z","timestamp":1730160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The COVID-19 pandemic has brought significant attention to the respiratory system, with much focus on lung-related disorders. However, the diaphragm, a crucial component of respiratory physiology, has not been adequately studied, especially in the context of long COVID. This review explores the multipotential role of the diaphragm in both respiratory health and disease, emphasizing its involvement in long-term complications following SARS-CoV-2 infection. The diaphragm\u2019s fundamental role in respiratory physiology and its impact on balance and posture control, breathing patterns, and autonomic nervous system regulation are discussed. This review examines complications arising from COVID-19, highlighting the diaphragm\u2019s involvement in neurological, musculoskeletal, and inflammatory responses. Particular attention is given to the neuroinvasive impact of SARS-CoV-2, the inflammatory response, and the direct viral effects on the diaphragm. The diaphragm\u2019s role in long COVID is explored, with a focus on specific symptoms such as voice disorders, pelvic floor dysfunction, and sleep disturbances. Diagnostic challenges, current methods for assessing diaphragmatic dysfunction, and the complexities of differentiating it from other conditions are also explored. This article is the first to comprehensively address diaphragmatic dysfunction resulting from COVID-19 and long COVID across various physiological and pathological aspects, offering a new perspective on its diagnosis and treatment within a multisystem context.<\/jats:p>","DOI":"10.3390\/jcm13216493","type":"journal-article","created":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T12:09:18Z","timestamp":1730203758000},"page":"6493","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of COVID-19 on Diaphragmatic Function: Understanding Multiorgan Involvement and Long-Term Consequences"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5286-9002","authenticated-orcid":false,"given":"Katarzyna Anna","family":"Pietranis","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, Medical University of Bialystok, 24A M. Sk\u0142odowskiej-Curie St., 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda Maria","family":"Kostro","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Medical University of Bialystok, 24A M. Sk\u0142odowskiej-Curie St., 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5139-2321","authenticated-orcid":false,"given":"Zofia","family":"Dzi\u0119cio\u0142-Anikiej","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Medical University of Bialystok, 24A M. Sk\u0142odowskiej-Curie St., 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Moskal-Jasi\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Clinical Phonoaudiology and Speech Therapy, Medical University of Bialystok, 37 Szpitalna St., 15-295 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5287-0401","authenticated-orcid":false,"given":"Anna","family":"Kuryliszyn-Moskal","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Medical University of Bialystok, 24A M. Sk\u0142odowskiej-Curie St., 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/S1473-3099(20)30086-4","article-title":"Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: A descriptive study","volume":"20","author":"Shi","year":"2020","journal-title":"Lancet Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1007\/s11739-022-02950-w","article-title":"Residual symptoms, lung function, and imaging findings in patients recovering from SARS-CoV-2 infection","volume":"17","author":"Darawshy","year":"2022","journal-title":"Intern. Emerg. Med."},{"key":"ref_3","first-page":"195","article-title":"Physiopathological mechanisms of diaphragmatic dysfunction associated with mechanical ventilation","volume":"67","year":"2020","journal-title":"Mec. Fisiopatol. Disfunc. Diafragm\u00e1tica Asoc. A Vent. Mec\u00e1nica. Rev. Esp. Anestesiol. Reanim."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"00346","DOI":"10.1183\/23120541.00346-2021","article-title":"Radiological-pathological signatures of patients with COVID-19-related pneumomediastinum: Is there a role for the Sonic hedgehog and Wnt5a pathways?","volume":"7","author":"Baratella","year":"2021","journal-title":"ERJ Open Res."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Khaire, N., Deshmukh, S., Agarwal, E., Mahale, N., Khaladkar, S., Desai, S., and Kulkarni, A. (2023). Pneumomediastinum: A marker of severity in COVID-19 disease. Heliyon, 9.","DOI":"10.1016\/j.heliyon.2023.e12981"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Daher, A., Balfanz, P., Cornelissen, C., M\u00fcller, A., Bergs, I., Marx, N., M\u00fcller-Wieland, D., Hartmann, B., Dreher, M., and M\u00fcller, T. (2020). Follow up of patients with severe coronavirus disease 2019 (COVID-19): Pulmonary and extrapulmonary disease sequelae. Respir. Med., 174.","DOI":"10.1016\/j.rmed.2020.106197"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1164\/rccm.202206-1243OC","article-title":"Diaphragm Muscle Weakness Might Explain Exertional Dyspnea 15 Months after Hospitalization for COVID-19","volume":"207","author":"Regmi","year":"2023","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Kang, D.H., Kim, G.H.J., Park, S.B., Lee, S.-I., Koh, J.S., Brown, M.S., Abtin, F., McNitt-Gray, M.F., Goldin, J.G., and Lee, J.S. (2024). Quantitative Computed Tomography Lung COVID Scores with Laboratory Markers: Utilization to Predict Rapid Progression and Monitor Longitudinal Changes in Patients with Coronavirus 2019 (COVID-19) Pneumonia. Biomedicines, 12.","DOI":"10.3390\/biomedicines12010120"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1164\/rccm.201312-2260LE","article-title":"Diaphragm fiber strength is reduced in critically ill patients and restored by a troponin activator","volume":"189","author":"Hooijman","year":"2014","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1164\/rccm.201412-2214OC","article-title":"Diaphragm muscle fiber weakness and ubiquitin-proteasome activation in critically ill patients","volume":"191","author":"Hooijman","year":"2015","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Iranpour, Y., and Zandifar, A. (2024). Diaphragm muscle parameters as a predictive tool for weaning critically ill patients from mechanical ventilation: A systematic review and meta-analysis study. Eur. J. Transl. Myol., 34.","DOI":"10.4081\/ejtm.2024.12642"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"564","DOI":"10.4187\/respcare.06391","article-title":"Evaluation of Diaphragmatic Ultrasound Indices as Predictors of Successful Liberation from Mechanical Ventilation in Subjects with Abdominal Sepsis","volume":"64","author":"Eltrabili","year":"2019","journal-title":"Respir. Care."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1177\/09612033241226755","article-title":"The effect of respiratory muscle training on respiratory muscle strength, diaphragm thickness\/mobility, and exercise capacity in patients with systemic lupus erythematosus and associated shrinking lung syndrome","volume":"33","author":"Sari","year":"2024","journal-title":"Lupus"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Li, M., Huang, Y., Chen, H., Wang, S., Zhou, Y., and Zhang, Y. (2024). Relationship between motor dysfunction, the respiratory muscles and pulmonary function in stroke patients with hemiplegia: A retrospective study. BMC Geriatr., 24.","DOI":"10.1186\/s12877-023-04647-x"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1620\/tjem.245.79","article-title":"Decreased Respiratory Muscle Function Is Associated with Impaired Trunk Balance among Chronic Stroke Patients: A Cross-sectional Study","volume":"245","author":"Lee","year":"2018","journal-title":"Tohoku J. Exp. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10974-012-9330-9","article-title":"Contribution of oxidative stress to pathology in diaphragm and limb muscles with Duchenne muscular dystrophy","volume":"34","author":"Kim","year":"2013","journal-title":"J. Muscle Res. Cell Motil."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1152\/japplphysiol.00248.2021","article-title":"Diaphragm muscle fibrosis involves changes in collagen organization with mechanical implications in Duchenne muscular dystrophy","volume":"132","author":"Sahani","year":"2022","journal-title":"J. Appl. Physiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"478","DOI":"10.2174\/138945011794751474","article-title":"Respiratory muscle dysfunction in COPD: From muscles to cell","volume":"12","author":"Klimathianaki","year":"2011","journal-title":"Curr. Drug Targets"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Yousefiyan, R., Kordi Yoosefinejad, A., Jalli, R., and Rezaei, I. (2023). Comparison of breathing pattern and diaphragmatic motion in patients with unilateral cervical radiculopathy and asymptomatic group. BMC Pulm. Med., 23.","DOI":"10.1186\/s12890-023-02804-x"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1067\/j.cpradiol.2015.07.010","article-title":"Diaphragm Appearance: A Clue to the Diagnosis of Pulmonary and Extrapulmonary Pathology","volume":"46","author":"Waite","year":"2017","journal-title":"Curr. Probl. Diagn. Radiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"E51","DOI":"10.1148\/rg.322115127","article-title":"Imaging of the diaphragm: Anatomy and function","volume":"32","author":"Nason","year":"2012","journal-title":"Radiographics"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.pulmoe.2018.10.008","article-title":"Diaphragmatic dysfunction","volume":"25","author":"Ricoy","year":"2019","journal-title":"Pulmonology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.thorsurg.2009.08.002","article-title":"Surgical conditions of the diaphragm: Anatomy and physiology","volume":"19","author":"Anraku","year":"2009","journal-title":"Thorac. Surg. Clin."},{"key":"ref_24","first-page":"224","article-title":"Network of breathing","volume":"85","author":"Kocjan","year":"2017","journal-title":"Multifunct. Role Diaphragm Rev. Adv. Respir. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.jbmt.2023.07.008","article-title":"Diaphragm and core stabilization exercises in low back pain: A narrative review","volume":"36","author":"Sannasi","year":"2023","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Safavi, S., Arthofer, C., Cooper, A., Harkin, J.W., Prayle, A.P., Sovani, M.P., Bolton, C.E., Gowland, P.A., and Hall, I.P. (2020). Assessing the impact of posture on diaphragm morphology and function using an open upright MRI system-A pilot study. Eur. J. Radiol., 130.","DOI":"10.1016\/j.ejrad.2020.109196"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.thorsurg.2011.01.001","article-title":"Anatomy of the normal diaphragm","volume":"21","author":"Downey","year":"2011","journal-title":"Thorac. Surg. Clin."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Vostatek, P., Nov\u00e1k, D., Rychnovsk\u00fd, T., and Rychnovsk\u00e1, S. (2013). Diaphragm postural function analysis using magnetic resonance imaging. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0056724"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Jung, J.Y., and Kang, C.K. (2021). Investigation on the Effect of Oral Breathing on Cognitive Activity Using Functional Brain Imaging. Healthcare, 9.","DOI":"10.3390\/healthcare9060645"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1080\/00207454.2019.1667787","article-title":"EEG signals during mouth breathing in a working memory task","volume":"130","author":"Lee","year":"2020","journal-title":"Int. J. Neurosci."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Kocjan, J., Gzik-Zroska, B., Nowakowska, K., Burkacki, M., Sucho\u0144, S., Michnik, R., Czy\u017cewski, D., and Adamek, M. (2018). Impact of diaphragm function parameters on balance maintenance. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0208697"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Wang, C., Yang, J., Qiao, L., Xu, Y., Yu, L., Wang, J., Ni, W., Wang, Y., and Yao, Y. (2022). Comparing the Effects of Short-Term Liuzijue Exercise and Core Stability Training on Balance Function in Patients Recovering from Stroke: A Pilot Randomized Controlled Trial. Front. Neurol., 13.","DOI":"10.3389\/fneur.2022.748754"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.pulmoe.2019.11.009","article-title":"Balance impairment in chronic respiratory patients","volume":"26","author":"Oliveira","year":"2020","journal-title":"Pulmonology"},{"key":"ref_34","first-page":"411","article-title":"Efficacy of iliopsoas muscle release on respiratory parameters in patients with chronic low back pain: A single blinded, two- groups, pre-test\/post-test randomized controlled trial protocol","volume":"11","author":"Vats","year":"2021","journal-title":"J. Physiother. Res. Salvador"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.resp.2013.05.028","article-title":"Greater diaphragm fatigability in individuals with recurrent low back pain","volume":"188","author":"Janssens","year":"2013","journal-title":"Respir. Physiol. Neurobiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/0304-3940(91)90207-A","article-title":"The transduction properties of diaphragmatic mechanoreceptors","volume":"122","author":"Holt","year":"1991","journal-title":"Neurosci. Lett."},{"key":"ref_37","first-page":"189","article-title":"Diaphragmatic fatigue in man","volume":"43","author":"Roussos","year":"1977","journal-title":"J. Appl. Physiol. Respir. Env. Exerc. Physiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/B978-0-323-91534-2.00012-6","article-title":"The phrenic neuromuscular system","volume":"188","author":"Fuller","year":"2022","journal-title":"Handb. Clin. Neurol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1111\/echo.15275","article-title":"The many paths to diagnose diaphragmatic paralysis: Cardiopulmonary ultrasound on stage","volume":"39","author":"Fontoura","year":"2022","journal-title":"Echocardiography"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1111\/j.1747-0803.2010.00431.x","article-title":"Diagnosis of abnormal diaphragm motion after cardiothoracic surgery: Ultrasound performed by a cardiac intensivist vs. fluoroscopy","volume":"5","author":"Munoz","year":"2010","journal-title":"Congenit. Heart Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2975","DOI":"10.1152\/jn.00484.2017","article-title":"Anatomy and physiology of phrenic afferent neurons","volume":"118","author":"Nair","year":"2017","journal-title":"J. Neurophysiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/0165-1838(92)90132-Z","article-title":"Characteristics of sympathetic reflexes evoked by electrical stimulation of phrenic nerve afferents","volume":"41","author":"Offner","year":"1992","journal-title":"J. Auton. Nerv. Syst."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1111\/j.1469-7793.1998.919bp.x","article-title":"The canine phrenic-to-intercostal reflex","volume":"508","year":"1998","journal-title":"J. Physiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1183\/09031936.00036813","article-title":"Predictors of dyspnoea prevalence: Results from the BOLD study","volume":"43","author":"Vollmer","year":"2014","journal-title":"Eur. Respir. J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1113\/jphysiol.2009.181735","article-title":"Phrenic nerve afferent activation of neurons in the cat SI cerebral cortex","volume":"588","author":"Davenport","year":"2010","journal-title":"J. Physiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.resp.2008.10.001","article-title":"Cortical and subcortical central neural pathways in respiratory sensations","volume":"167","author":"Davenport","year":"2009","journal-title":"Respir Physiol. Neurobiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1093\/icvts\/ivw091","article-title":"In patients with a tumour invading the phrenic nerve does prophylactic diaphragm plication improve postoperative lung function?","volume":"23","author":"Beattie","year":"2016","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Vagnozzi, A.N., Garg, K., Dewitz, C., Moore, M.T., Cregg, J.M., Jeannotte, L., Zampieri, N., Landmesser, L.T., and Philippidou, P. (2020). Phrenic-specific transcriptional programs shape respiratory motor output. Elife, 9.","DOI":"10.7554\/eLife.52859"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1152\/japplphysiol.00036.2016","article-title":"Heme oxygenase-1-dependent central cardiorespiratory adaptations to chronic intermittent hypoxia in mice","volume":"121","author":"Sunderram","year":"2016","journal-title":"J. Appl. Physiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e826","DOI":"10.1093\/milmed\/usab056","article-title":"The Successful Use of Left-sided Stellate Ganglion Block in Patients That Fail to Respond to Right-sided Stellate Ganglion Block for the Treatment of Post-traumatic Stress Disorder Symptoms: A Retrospective Analysis of 205 Patients","volume":"187","author":"Mulvaney","year":"2022","journal-title":"Mil. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"R466","DOI":"10.1152\/ajpregu.00079.2020","article-title":"Eight weeks of device-guided slow breathing decreases sympathetic nervous reactivity to stress in posttraumatic stress disorder","volume":"319","author":"Fonkoue","year":"2020","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s15010-020-01474-9","article-title":"Pulmonary function in patients surviving to COVID-19 pneumonia","volume":"49","author":"Fumagalli","year":"2021","journal-title":"Infection"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1002\/jmv.26424","article-title":"Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes","volume":"93","author":"Li","year":"2021","journal-title":"J. Med. Virol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Flisiak, R., Horban, A., Jaroszewicz, J., Kozielewicz, D., Mastalerz-Migas, A., Owczuk, R., Parczewski, M., Pawlowska, M., Piek-Arska, A., and Simon, K. (2021). Diagnosis and therapy of SARS-CoV-2 infection: Recommendations of the Polish Association of Epidemiologists and Infectiologists as of November 12, 2021. Annex no. 1 to the Recommendations of April 26, 2021. Pol. Arch. Intern. Med., 131.","DOI":"10.20452\/pamw.15979"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Guler, S.A., Ebner, L., Aubry-Beigelman, C., Bridevaux, P.-O., Brutsche, M., Clarenbach, C., Garzoni, C., Geiser, T.K., Lenoir, A., and Mancinetti, M. (2021). Pulmonary function and radiological features 4 months after COVID-19: First results from the national prospective observational Swiss COVID-19 lung study. Eur. Respir. J., 57.","DOI":"10.1183\/13993003.03690-2020"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1001\/jamaneurol.2020.1127","article-title":"Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China","volume":"77","author":"Mao","year":"2020","journal-title":"JAMA Neurol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/ane.13266","article-title":"Neurological Manifestations of COVID-19: A systematic review and current update","volume":"142","author":"Whittaker","year":"2020","journal-title":"Acta Neurol. Scand."},{"key":"ref_58","first-page":"283","article-title":"SARS-CoV-2 infection of the nervous system: A review of the literature on neurological involvement in novel coronavirus disease-(COVID-19)","volume":"20","author":"Payus","year":"2020","journal-title":"Bosn. J. Basic Med. Sci."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2406","DOI":"10.1038\/s41591-022-02001-z","article-title":"Long-term neurologic outcomes of COVID-19","volume":"28","author":"Xu","year":"2022","journal-title":"Nat. Med."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Kokatnur, L., and Rudrappa, M. (2018). Diaphragmatic Palsy. Diseases, 6.","DOI":"10.3390\/diseases6010016"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1001\/jamainternmed.2020.6278","article-title":"Diaphragm Pathology in Critically Ill Patients with COVID-19 and Postmortem Findings from 3 Medical Centers","volume":"181","author":"Shi","year":"2021","journal-title":"JAMA Intern. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s10571-020-00915-1","article-title":"Expression of ACE2 in Human Neurons Supports the Neuro-Invasive Potential of COVID-19 Virus","volume":"42","author":"Xu","year":"2022","journal-title":"Cell. Mol. Neurobiol."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Guadarrama-Ortiz, P., Chore\u00f1o-Parra, J.A., S\u00e1nchez-Mart\u00ednez, C.M., Pacheco-S\u00e1nchez, F.J., Rodr\u00edguez-Nava, A.I., and Garc\u00eda-Quintero, G. (2020). Neurological Aspects of SARS-CoV-2 Infection: Mechanisms and Manifestations. Front. Neurol., 11.","DOI":"10.3389\/fneur.2020.01039"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"3039","DOI":"10.1007\/s10072-020-04708-8","article-title":"Neuromuscular presentations in patients with COVID-19","volume":"41","author":"Paliwal","year":"2020","journal-title":"Neurol. Sci."},{"key":"ref_65","unstructured":"Maurier, F., Godbert, B., and Perrin, J. (2020). Respiratory Distress in SARS-CoV-2 without Lung Damage: Phrenic Paralysis Should Be Considered in COVID-19 Infection. Eur. J. Case Rep. Intern. Med., 7."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Shahid, M., Ali Nasir, S., Shahid, O., Nasir, S.A., and Khan, M.W. (2021). Unilateral Diaphragmatic Paralysis in a Patient with COVID-19 Pneumonia. Cureus, 13.","DOI":"10.7759\/cureus.19322"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"FitzMaurice, T.S., McCann, C., Walshaw, M., and Greenwood, J. (2021). Unilateral diaphragm paralysis with COVID-19 infection. BMJ Case Rep., 14.","DOI":"10.1136\/bcr-2021-243115"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Alrosan, S., Lem, V.M., and Abu-Jeyyab, M. (2023). A Bilateral Diaphragmatic Paralysis Post-COVID-19 Infection: A Case Report and a Review of the Literature. Cureus, 15.","DOI":"10.7759\/cureus.35791"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1186\/s43055-021-00527-9","article-title":"Recognition of phrenic paralysis as atypical presentation during CT chest examination of COVID-19 infection and its correlation with CT severity scoring: A local experience during pandemic era","volume":"52","author":"Abdeldayem","year":"2021","journal-title":"Egypt. J. Radiol. Nucl. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1002\/jmv.26232","article-title":"The cytokine storm and COVID-19","volume":"93","author":"Hu","year":"2021","journal-title":"J. Med. Virol."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Forcina, L., Miano, C., Scicchitano, B.M., Rizzuto, E., Berardinelli, M.G., De Benedetti, F., Pelosi, L., and Musar\u00f2, A. (2019). Increased Circulating Levels of Interleukin-6 Affect the Redox Balance in Skeletal Muscle. Oxidative Med. Cell Longev., 2019.","DOI":"10.1155\/2019\/3018584"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1986","DOI":"10.1056\/NEJMoa030685","article-title":"A major outbreak of severe acute respiratory syndrome in Hong Kong","volume":"348","author":"Lee","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1038\/nrrheum.2011.39","article-title":"Pathogenesis, classification and treatment of inflammatory myopathies","volume":"7","author":"Zong","year":"2011","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2781","DOI":"10.1093\/hmg\/ddx173","article-title":"Oxidative stress in Duchenne muscular dystrophy: Focus on the NRF2 redox pathway","volume":"26","author":"Petrillo","year":"2017","journal-title":"Hum. Mol. Genet."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Pelosi, L., Forcina, L., Nicoletti, C., Scicchitano, B.M., and Musar\u00f2, A. (2017). Increased Circulating Levels of Interleukin-6 Induce Perturbation in Redox-Regulated Signaling Cascades in Muscle of Dystrophic Mice. Oxid. Med. Cell Longev., 2017.","DOI":"10.1155\/2017\/1987218"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"142","DOI":"10.62347\/TXVO6284","article-title":"Advance in the mechanism and clinical research of myalgia in long COVID","volume":"13","author":"Zhai","year":"2024","journal-title":"Am. J. Clin. Exp. Immunol."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-Vi\u00f1as, L., Vega-Villar, J., Roc\u00edo-Mart\u00edn, E., Garc\u00eda-Garc\u00eda, P., Santiago, E.D.L.R., Galv\u00e1n-Rom\u00e1n, J.M., and Wix-Ramos, R. (2022). Diaphragm impairment in patients admitted for severe COVID-19. Eur. J. Transl. Myol., 32.","DOI":"10.4081\/ejtm.2022.10460"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"718","DOI":"10.34172\/aim.2020.93","article-title":"A Rare Axonal Variant of Guillain-Barr\u00e9 Syndrome as a Neurological Complication of COVID-19 Infection","volume":"23","author":"Karbasi","year":"2020","journal-title":"Arch. Iran. Med."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1007\/s00415-020-10124-x","article-title":"Guillain-Barr\u00e9 syndrome spectrum associated with COVID-19: An up-to-date systematic review of 73 cases","volume":"268","author":"Abdelhak","year":"2021","journal-title":"J. Neurol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1007\/s13365-021-00984-y","article-title":"Guillain-Barr\u00e9 syndrome associated with COVID-19: A case report study","volume":"27","author":"Nejad","year":"2021","journal-title":"J. Neurovirol."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"\u017divkovi\u0107, V., Ga\u010di\u0107, E.M., Djuki\u0107, D., and Nikoli\u0107, S. (2022). Guillain-Barr\u00e9 syndrome as a fatal complication of SARS-CoV-2 infection\u2014An autopsy case. Leg. Med., 57.","DOI":"10.1016\/j.legalmed.2022.102074"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Mittal, A., Dua, A., Gupta, S., and Injeti, E. (2021). A research update: Significance of cytokine storm and diaphragm in COVID-19. Curr. Res. Pharmacol. Drug Discov., 2.","DOI":"10.1016\/j.crphar.2021.100031"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1002\/jcsm.12739","article-title":"Severe loss of mechanical efficiency in COVID-19 patients","volume":"12","author":"Pleguezuelos","year":"2021","journal-title":"J. Cachexia. Sarcopenia. Muscle."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Dams, K., De Meyer, G.R., Jacobs, R., Schepens, T., Perkisas, S., Moorkens, G., and Jorens, P. (2024). Combined ultrasound of m. quadriceps and diaphragm to determine the occurrence of sarcopenia and prolonged ventilation in a COVID-19 ICU cohort: The COVID-SARCUS trial. Nutrition, 117.","DOI":"10.1016\/j.nut.2023.112250"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1002\/jcsm.12941","article-title":"Effects of resistance training intensity on muscle quantity\/quality in middle-aged and older people: A randomized controlled trial","volume":"13","author":"Otsuka","year":"2022","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Cernea, A., Fern\u00e1ndez-Mart\u00ednez, J.L., de Andr\u00e9s-Galiana, E.J., Fern\u00e1ndez-Mu\u00f1iz, Z., Bermejo-Millo, J.C., Gonz\u00e1lez-Blanco, L., Solano, J.J., Abizanda, P., Coto-Montes, A., and Caballero, B. (2019). Prognostic networks for unraveling the biological mechanisms of Sarcopenia. Mech. Ageing Dev., 182.","DOI":"10.1016\/j.mad.2019.111129"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.clnesp.2022.01.016","article-title":"Coronavirus disease 2019 (COVID-19) outcomes in patients with sarcopenia: A meta-analysis and meta-regression","volume":"48","author":"Siahaan","year":"2022","journal-title":"Clin. Nutr. ESPEN."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Sagarra-Romero, L., and Vi\u00f1as-Barros, A. (2020). COVID-19: Short and Long-Term Effects of Hospitalization on Muscular Weakness in the Elderly. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17238715"},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Wang, P.Y., Li, Y., and Wang, Q. (2021). Sarcopenia: An underlying treatment target during the COVID-19 pandemic. Nutrition, 84.","DOI":"10.1016\/j.nut.2020.111104"},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Bellanti, F., Buglio, A.L., Stasio, E.D., di Bello, G., Tamborra, R., Dobrakowski, M., Kasperczyk, A., Kasperczyk, S., and Vendemiale, G. (2020). An open-label, single-center pilot study to test the effects of an amino acid mixture in older patients admitted to internal medicine wards. Nutrition, 69.","DOI":"10.1016\/j.nut.2019.110588"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/ggi.13547","article-title":"Effects of branched-chain amino acids and vitamin D supplementation on physical function, muscle mass and strength, and nutritional status in sarcopenic older adults undergoing hospital-based rehabilitation: A multicenter randomized controlled trial","volume":"19","author":"Takeuchi","year":"2019","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"de Andrade-Junior, M.C., de Salles, I.C.D., de Brito, C.M.M., Pastore-Junior, L., Righetti, R.F., and Yamaguti, W.P. (2021). Skeletal Muscle Wasting and Function Impairment in Intensive Care Patients with Severe COVID-19. Front. Physiol., 12.","DOI":"10.3389\/fphys.2021.640973"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.jcrc.2021.11.014","article-title":"Time course of the Bioelectrical Impedance Vector Analysis and muscular ultrasound in critically ill patients","volume":"68","author":"Formenti","year":"2022","journal-title":"J. Crit. Care"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"432","DOI":"10.23736\/S0375-9393.21.15129-6","article-title":"Low diaphragm muscle mass predicts adverse outcome in patients hospitalized for COVID-19 pneumonia: An exploratory pilot study","volume":"87","author":"Corradi","year":"2021","journal-title":"Minerva Anestesiol."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Hadda, V., Raja, A., Suri, T.M., Khan, M.A., Mittal, S., Madan, K., and Mohan, A. (2023). Temporal evolution of diaphragm thickness and diaphragm excursion among subjects hospitalized with COVID-19: A prospective observational study. Respir. Med. Res., 83.","DOI":"10.1016\/j.resmer.2022.100960"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1080\/23744235.2021.1924397","article-title":"Long COVID or post-COVID-19 syndrome: Putative pathophysiology, risk factors, and treatments","volume":"53","author":"Yong","year":"2021","journal-title":"Infect. Dis."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Lechner-Scott, J., Levy, M., Hawkes, C., Yeh, A., and Giovannoni, G. (2021). Long COVID or post COVID-19 syndrome. Mult. Scler. Relat. Disord., 55.","DOI":"10.1016\/j.msard.2021.103268"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"3484","DOI":"10.1016\/j.neuron.2022.10.006","article-title":"The neurobiology of long COVID","volume":"110","author":"Monje","year":"2022","journal-title":"Neuron"},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"Lippi, G., Sanchis-Gomar, F., and Henry, B.M. (2023). COVID-19 and its long-term sequelae: What do we know in 2023?. Pol. Arch. Intern. Med., 133.","DOI":"10.20452\/pamw.16402"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.2106\/JBJS.20.00847","article-title":"Musculoskeletal Consequences of COVID-19","volume":"102","author":"Disser","year":"2020","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1007\/s40520-021-01885-0","article-title":"Skeletal muscle weakness in older adults home-restricted due to COVID-19 pandemic: A role for full-body in-bed gym and functional electrical stimulation","volume":"33","author":"Carraro","year":"2021","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_102","first-page":"310","article-title":"Patients recovering from COVID-19 pneumonia at a sub-acute admissions unit exhibit profound muscular weakness","volume":"57","author":"DIPietro","year":"2021","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref_103","first-page":"819","article-title":"Pulmonale Manifestationen bei Long-COVID [Pulmonary manifestations in long COVID]","volume":"63","author":"Sommer","year":"2022","journal-title":"Inn. Med."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Han, X., Chen, L., Fan, Y., Alwalid, O., Jia, X., Zheng, Y., Liu, J., Li, Y., Cao, Y., and Gu, J. (2023). Longitudinal Assessment of Chest CT Findings and Pulmonary Function after COVID-19 Infection. Radiology, 307.","DOI":"10.1148\/radiol.222888"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1159\/000535391","article-title":"Predictors for Long COVID and Differences in Long COVID Symptoms, Findings on Chest Imaging and Pulmonary Function between Hospitalized COVID-19 Patients with versus without Intensive Care Unit Admission","volume":"103","author":"Moeniralam","year":"2024","journal-title":"Respiration"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1159\/000518141","article-title":"Six-Month Pulmonary Impairment after Severe COVID-19: A Prospective, Multicentre Follow-Up Study","volume":"100","author":"Faverio","year":"2021","journal-title":"Respiration"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1186\/s12931-022-02100-y","article-title":"Diaphragm dysfunction as a potential determinant of dyspnea on exertion in patients 1 year after COVID-19-related ARDS","volume":"23","author":"Spiesshoefer","year":"2022","journal-title":"Respir. Res."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1007\/s15010-022-01840-9","article-title":"Respiratory muscle dysfunction in long-COVID patients","volume":"50","author":"Hennigs","year":"2022","journal-title":"Infection"},{"key":"ref_109","doi-asserted-by":"crossref","unstructured":"Dong, Z., Liu, Y., Gai, Y., Meng, P., Lin, H., Zhao, Y., and Xing, J. (2021). Early rehabilitation relieves diaphragm dysfunction induced by prolonged mechanical ventilation: A randomised control study. BMC Pulm. Med., 21.","DOI":"10.1186\/s12890-021-01461-2"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1016\/j.chest.2017.08.1157","article-title":"Diaphragm Dysfunction in Critical Illness","volume":"153","author":"Supinski","year":"2018","journal-title":"Chest"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1177\/08850666231169494","article-title":"Prognostic Value of Diaphragm Diameter, Muscle Volume, and Bone Mineral Density in Critically Ill COVID-19 Patients","volume":"38","author":"Emekli","year":"2023","journal-title":"J. Intensive Care Med."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1164\/rccm.201602-0367OC","article-title":"Coexistence and Impact of Limb Muscle and Diaphragm Weakness at Time of Liberation from Mechanical Ventilation in Medical Intensive Care Unit Patients","volume":"195","author":"Dres","year":"2017","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.jbmt.2023.04.064","article-title":"Effect of diaphragm manual release versus conventional breathing exercises and prone positioning on physical functional performance in women with COVID-19: A randomized trial","volume":"35","author":"Ahmad","year":"2023","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"Vieira da Costa, K., Tain\u00e1 Cordeiro de Souza, I., Felix, J.V.D.S., Brand\u00e3o, C.B.F., Fernandes, V.M.D.S., Favero, A.B.L., Gouveia, M.L.D.A., de Lima, D.T., Lima, J.H.d.M., and Pedrosa, R. (2022). Efficacy of a rehabilitation protocol on pulmonary and respiratory muscle function and ultrasound evaluation of diaphragm and quadriceps femoris in patients with post-COVID-19 syndrome: A series of cases. Monaldi Arch. Chest Dis., 93.","DOI":"10.4081\/monaldi.2022.2206"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1002\/acn3.51416","article-title":"Diaphragm dysfunction in severe COVID-19 as determined by neuromuscular ultrasound","volume":"8","author":"Farr","year":"2021","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1177\/1941874416663279","article-title":"Review of Critical Illness Myopathy and Neuropathy","volume":"7","author":"Shepherd","year":"2017","journal-title":"Neurohospitalist"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/s41467-023-44432-3","article-title":"Muscle abnormalities worsen after post-exertional malaise in long COVID","volume":"15","author":"Appelman","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1164\/rccm.202108-1903LE","article-title":"Decreased Fatty Acid Oxidation and Altered Lactate Production during Exercise in Patients with Post-acute COVID-19 Syndrome","volume":"205","author":"Petrache","year":"2022","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s40279-022-01751-7","article-title":"Low Cardiorespiratory Fitness Post-COVID-19: A Narrative Review","volume":"53","author":"Schwendinger","year":"2023","journal-title":"Sports Med."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.chest.2021.08.010","article-title":"Persistent Exertional Intolerance After COVID-19: Insights from Invasive Cardiopulmonary Exercise Testing","volume":"161","author":"Singh","year":"2022","journal-title":"Chest"},{"key":"ref_121","first-page":"11","article-title":"Zaburzenia g\u0142osu a pandemia COVID-19 [Voice Disorders and the COVID-19 Pandemic]","volume":"8","author":"Gacka","year":"2023","journal-title":"Logop. Lodz."},{"key":"ref_122","first-page":"99","article-title":"Terapia logopedyczna pacjent\u00f3w po przebytej infekcji COVID-19. [Speech therapy of patients after COVID-19 infection]","volume":"45\u201346","author":"Gacka","year":"2022","journal-title":"Niepe\u0142nosprawno\u015b\u0107. Dyskursy Pedagogiki Specjalnej. Disabil. Discourses Spec. Educ."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/S2213-2600(21)00125-9","article-title":"Confronting COVID-19-associated cough and the post-COVID syndrome: Role of viral neurotropism, neuroinflammation, and neuroimmune responses","volume":"9","author":"Song","year":"2021","journal-title":"Lancet Respir. Med."},{"key":"ref_124","doi-asserted-by":"crossref","unstructured":"Milner, M., Gamble, M., and Barry-Kinsella, C. (2022). COVID-19, pelvic health, and women\u2019s voices: A descriptive study. Continence, 1.","DOI":"10.1016\/j.cont.2022.100012"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1590\/s1677-5538.ibju.2022.0281","article-title":"Urological complications of COVID-19: A systematic review","volume":"49","author":"Bresler","year":"2023","journal-title":"Int. Braz. J. Urol."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1007\/s11255-023-03700-3","article-title":"COVID-associated cystitis: The culprit behind the bladder woes post-COVID infection? A review","volume":"55","author":"Dhawan","year":"2023","journal-title":"Int. Urol. Nephrol."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1097\/JWH.0000000000000180","article-title":"Pelvic Floor Considerations in COVID-19","volume":"44","author":"Siracusa","year":"2020","journal-title":"J. Womens Health Phys. Therap."},{"key":"ref_128","first-page":"1","article-title":"150 Self-Reported Urinary Incontinence During COVID-19 Infection and After Recovery: A Preliminary Report with Brazilian Survivors","volume":"2","author":"Sousa","year":"2022","journal-title":"Continence"},{"key":"ref_129","doi-asserted-by":"crossref","unstructured":"Carlin, G.L., Kimberger, O., Morgenbesser, R., Umek, W., K\u00f6lbl, H., Bodner, K., and Bodner-Adler, B. (2021). Female Pelvic Floor Dysfunction Continues to Negatively Impact Quality-of-Life during the COVID-19 Lockdown. J. Clin. Med., 10.","DOI":"10.3390\/jcm10051075"},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"26","DOI":"10.4103\/0028-3886.310073","article-title":"Sleep and COVID-19","volume":"69","author":"Datta","year":"2021","journal-title":"Neurol. India"},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.sleep.2020.11.013","article-title":"COVID-19 and OSA: Exploring multiple cross-ways","volume":"79","author":"Saxena","year":"2021","journal-title":"Sleep Med."},{"key":"ref_132","doi-asserted-by":"crossref","unstructured":"L\u00e9vy, P., Kohler, M., McNicholas, W.T., Barb\u00e9, F., McEvoy, R.D., Somers, V.K., Lavie, L., and P\u00e9pin, J.L. (2015). Obstructive sleep apnoea syndrome. Nat. Rev. Dis. Primers, 1.","DOI":"10.1038\/nrdp.2015.15"},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/jsr.12337","article-title":"Diaphragm and genioglossus corticomotor excitability in patients with obstructive sleep apnea and control subjects","volume":"25","author":"Borel","year":"2016","journal-title":"J. Sleep Res."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1007\/s11325-021-02472-3","article-title":"Examination of the diaphragm in obstructive sleep apnea using ultrasound imaging","volume":"26","author":"Lakner","year":"2022","journal-title":"Sleep Breath"},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1164\/ajrccm\/142.3.533","article-title":"Respiratory muscle function during obstructive sleep apnea","volume":"142","author":"Wilcox","year":"1990","journal-title":"Am. Rev. Respir. Dis."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1183\/09031936.00190208","article-title":"Inspiratory muscle dysfunction in patients with severe obstructive sleep apnoea","volume":"35","author":"Chien","year":"2010","journal-title":"Eur. Respir. J."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1007\/s11055-022-01290-8","article-title":"Sleep Disorders in Patients after COVID-19","volume":"52","author":"Reikhert","year":"2022","journal-title":"Neurosci Behav Physiol."},{"key":"ref_138","doi-asserted-by":"crossref","unstructured":"American Thoracic Society\/European Respiratory Society (2002). ATS\/ERS Statement on respiratory muscle testing. Am. J. Respir. Crit. Care Med., 166, 518\u2013624.","DOI":"10.1164\/rccm.166.4.518"},{"key":"ref_139","doi-asserted-by":"crossref","unstructured":"Guimar\u00e3es-Costa, R., Similowski, T., Rivals, I., Mor\u00e9lot-Panzini, C., Nierat, M.-C., Bui, M.T., Akbar, D., Straus, C., Romero, N.B., and Michel, P.P. (2019). Human diaphragm atrophy in amyotrophic lateral sclerosis is not predicted by routine respiratory measures. Eur. Respir. J., 53.","DOI":"10.1183\/13993003.01749-2018"},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jsha.2011.02.031","article-title":"Can lung volumes and capacities be used as an outcome measure for phrenic nerve recovery after cardiac surgeries?","volume":"23","author":"Salem","year":"2011","journal-title":"J. Saudi Heart Assoc."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1002\/jum.15706","article-title":"Diaphragm and Phrenic Nerve Ultrasound in COVID-19 Patients and Beyond: Imaging Technique, Findings, and Clinical Applications","volume":"41","author":"Patel","year":"2022","journal-title":"J. Ultrasound Med."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1136\/thx.2006.072884","article-title":"The value of multiple tests of respiratory muscle strength","volume":"62","author":"Steier","year":"2007","journal-title":"Thorax"},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1002\/mus.26717","article-title":"Respiratory muscle weakness in facioscapulohumeral muscular dystrophy","volume":"60","author":"Henke","year":"2019","journal-title":"Muscle Nerve."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/j.nmd.2019.06.011","article-title":"The nature of respiratory muscle weakness in patients with late-onset Pompe disease","volume":"29","author":"Spiesshoefer","year":"2019","journal-title":"Neuromuscul. Disord."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.nmd.2019.10.011","article-title":"Characteristics of respiratory muscle involvement in myotonic dystrophy type 1","volume":"30","author":"Henke","year":"2020","journal-title":"Neuromuscul. Disord."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1136\/pgmj.74.870.208","article-title":"Assessment of respiratory muscle function and strength","volume":"74","author":"Syabbalo","year":"1998","journal-title":"Postgrad. Med. J."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"299","DOI":"10.5603\/ARM.a2021.0055","article-title":"Comprehensive assessment of respiratory function, a step towards early weaning from the ventilator","volume":"89","year":"2021","journal-title":"Adv. Respir. Med."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"2851","DOI":"10.1681\/ASN.2021060734","article-title":"Kidney Outcomes in Long COVID","volume":"32","author":"Bowe","year":"2021","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_149","first-page":"1891","article-title":"Long COVID: Where we stand and challenges ahead","volume":"29","author":"Mantovani","year":"2022","journal-title":"Cell Death Differ."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1016\/j.amjmed.2020.04.003","article-title":"Respiratory Muscle Performance Screening for Infectious Disease Management Following COVID-19: A Highly Pressurized Situation","volume":"133","author":"Severin","year":"2020","journal-title":"Am. J. Med."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.cmi.2023.11.007","article-title":"Vagus nerve dysfunction in the post-COVID-19 condition: A pilot cross-sectional study","volume":"30","author":"Massanella","year":"2024","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"e20","DOI":"10.1055\/s-0044-1787296","article-title":"Effects of COVID-19 Pandemic in Patients with a Previous Phrenic Nerve Transfer for a Traumatic Brachial Plexus Palsy","volume":"19","author":"Socolovsky","year":"2024","journal-title":"J. Brachial Plex. Peripher. Nerve Inj."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1056\/NEJMoa070447","article-title":"Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans","volume":"358","author":"Levine","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1136\/thoraxjnl-2021-218257","article-title":"COVID-19 associated phrenic nerve mononeuritis: A case series","volume":"77","author":"Law","year":"2022","journal-title":"Thorax"},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1164\/rccm.202301-0105ED","article-title":"Diaphragm Dysfunction as a Contributor to Breathlessness after COVID-19 Infection","volume":"207","author":"Polkey","year":"2023","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.pcad.2021.10.002","article-title":"Inspiratory muscle weakness in cardiovascular diseases: Implications for cardiac rehabilitation","volume":"70","author":"Smith","year":"2022","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1016\/j.jacc.2022.08.760","article-title":"Diaphragmatic Function in Cardiovascular Disease: JACC Review Topic of the Week","volume":"80","author":"Salah","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_158","doi-asserted-by":"crossref","unstructured":"Bordoni, B., Kotha, R., and Escher, A.R. (2024). Symptoms Arising from the Diaphragm Muscle: Function and Dysfunction. Cureus, 16.","DOI":"10.7759\/cureus.53143"},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1038\/ajg.2011.420","article-title":"Positive effect of abdominal breathing exercise on gastroesophageal reflux disease: A randomized, controlled study","volume":"107","author":"Eherer","year":"2012","journal-title":"Am. J. Gastroenterol."},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1183\/09031936.00018808","article-title":"Sleep-disordered breathing in unilateral diaphragm paralysis or severe weakness","volume":"32","author":"Steier","year":"2008","journal-title":"Eur. Respir. J."},{"key":"ref_161","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.12669\/pjms.36.6.2899","article-title":"Effectiveness of Pre-operative Respiratory Muscle Training versus Conventional Treatment for Improving Post operative Pulmonary Health after Coronary Artery Bypass Grafting","volume":"36","author":"Sahar","year":"2020","journal-title":"Pak. J. Med. Sci."},{"key":"ref_162","doi-asserted-by":"crossref","first-page":"150","DOI":"10.4187\/respcare.06919","article-title":"Physical Exercise Combined with CPAP in Subjects Who Underwent Surgical Myocardial Revascularization: A Randomized Clinical Trial","volume":"65","author":"Bodnar","year":"2020","journal-title":"Respir. 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