@article {Severin220006, author = {Richard Severin and Colin K. Franz and Ellen Farr and Cristiane Meirelles and Ross Arena and Shane A. Phillips and Sam Bond and Francesco Ferraro and Mark Faghy}, editor = {,}, title = {The effects of COVID-19 on respiratory muscle performance: making the case for respiratory muscle testing and training}, volume = {31}, number = {166}, elocation-id = {220006}, year = {2022}, doi = {10.1183/16000617.0006-2022}, publisher = {European Respiratory Society}, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection results in multiorgan damage primarily mediated by viral infiltration via angiotensin-converting enzyme-2 receptors on the surface of cells. A primary symptom for many patients is exertional dyspnoea which may persist even beyond recovery from the viral infection. Respiratory muscle (RM) performance was hypothesised as a contributing factor to the severity of coronavirus disease 2019 (COVID-19) symptoms, such as dyspnoea, and outcomes. This was attributed to similarities between patient populations at elevated risk for severe COVID-19 symptoms and those with a greater likelihood of baseline RM weakness and the effects of prolonged mechanical ventilation. More recent evidence suggests that SARS-CoV-2 infection itself may cause damage to the RM, and many patients who have recovered report persistent dyspnoea despite having mild cases, normal lung function or undamaged lung parenchyma. These more recent findings suggest that the role of RM in the persistent dyspnoea due to COVID-19 may be more substantial than originally hypothesised. Therefore, screening for RM weakness and providing interventions to improve RM performance appears to be important for patients with COVID-19. This article will review the impact of SARS-CoV-2 infection on RM performance and provide clinical recommendations for screening RM performance and treatment interventions.SARS-CoV-2 infection itself may cause damage to the respiratory muscles and may contribute to the acute and persistent dyspnoea in patients with COVID-19. Respiratory muscle testing and training appears to be important for patients with COVID-19. https://bit.ly/3vxwKGG}, issn = {0905-9180}, URL = {https://err.ersjournals.com/content/31/166/220006}, eprint = {https://err.ersjournals.com/content/31/166/220006.full.pdf}, journal = {European Respiratory Review} }