Critically ill COVID-19 patients develop virus-induced damage of respiratory muscles, scientists at Amsterdam UMC in The Netherlands reported on Monday in JAMA Internal Medicine. Autopsy studies of the diaphragm in 26 COVID-19 patients who died in the intensive care unit, as well as in 8 ICU patients who died without COVID-19, showed ACE2 receptors in diaphragm muscle cell membranes. The researchers found genetic evidence of the virus in diaphragm muscle cells in some of those who died from COVID-19, and microscopy analyses showed much more fibrosis in COVID-19 patients' diaphragms, indicating damage, study coauthor Coen Ottenheijm told Reuters. He said the diaphragm damage may help explain why it is often difficult to wean COVID-19 patients off mechanical ventilators in the ICU. It may also explain the persistent shortness of breath in patients recovering from COVID-19. —Reuters Staff Source