Long COVID – Hypotonia

Hypotonia (HP:0001252)

Hypotonia is an abnormally low muscle tone (the amount of tension or resistance to movement in a muscle). Even when relaxed, muscles have a continuous and passive partial contraction which provides some resistance to passive stretching. Hypotonia thus manifests as diminished resistance to passive stretching. Hypotonia is not the same as muscle weakness, although the two conditions can co-exist.

Synonyms:    Low muscle tone, Low or weak muscle tone, Muscle hypotonia, Muscular hypotonia, Central hypotonia, Peripheral hypotonia

Comment:    Hypotonia can be caused by abnormalities of the central nervous system, any element of the motor unit (including the lower motoneuron), or both. Hypotonia is not a specific diagnosis, but can be observed in hundreds of genetic and other diseases. The first distinction to make when assessing a child with hypotonia is whether decreased muscle tone is a result of an abnormality of the central nervous system (CNS), peripheral neuromuscular system, or a combined abnormality involving both. Clinical findings suggestive of an abnormality of the CNS may include hyperreflexia, cognitive developmental delay, and seizures. In contrast, physical findings pointing towards a neuromuscular origin may include weakness, lack of antigravity movements, muscle atrophy, fasciculations, and/or diminished reflexes, most often in the context of normal cognitive function. The HPO term does not distinguish between these etiologies. Additional HPO terms should be used as required to describe associated features.

Pubmed References:    PMID:21418198

Cross References:    MSH:D009123, SNOMEDCT_US:398151007, SNOMEDCT_US:398152000, UMLS:C0026827

KEGG Pathway

IndexNameP-valueAdjusted p-valueOdds RatioCombined score
1Oxidative phosphorylation1.197e-221.317e-21198670.0010028275.58
2Retrograde endocannabinoid signaling3.613e-221.987e-21198520.009801417.00
3Non-alcoholic fatty liver disease5.818e-222.133e-21198450.009703402.49
4Diabetic cardiomyopathy9.277e-212.551e-20197970.009131721.76
5Thermogenesis3.629e-207.983e-20197680.008848725.20

GO: Biological Process

IndexNameP-valueAdjusted p-valueOdds RatioCombined score
1mitochondrial electron transport, NADH to ubiquinone (GO:0006120)2.254e-284.958e-27199610.0012707139.91
2mitochondrial respiratory chain complex I assembly (GO:0032981)1.850e-261.357e-25199420.0011816020.17
3NADH dehydrogenase complex assembly (GO:0010257)1.850e-261.357e-25199420.0011816020.17
4aerobic electron transport chain (GO:0019646)1.407e-257.205e-25199300.0011404606.96
5mitochondrial ATP synthesis coupled electron transport (GO:0042775)1.637e-257.205e-25199290.0011373779.66

GO: Molecular Function

IndexNameP-valueAdjusted p-valueOdds RatioCombined score
1NADH dehydrogenase (quinone) activity (GO:0050136)5.000e-251.000e-246910.62386684.82
2NADH dehydrogenase (ubiquinone) activity (GO:0008137)5.000e-251.000e-246910.62386684.82
3oxidoreduction-driven active transmembrane transporter activity (GO:0015453)7.535e-231.005e-223662.63186574.14
4NADH dehydrogenase activity (GO:0003954)0.0000047190.000004719999.2512254.80

GO: Cellular Component

IndexNameP-valueAdjusted p-valueOdds RatioCombined score
1mitochondrial respiratory chain complex I (GO:0005747)5.216e-284.173e-27199580.0012537732.35
2respiratory chain complex I (GO:0045271)5.216e-284.173e-27199580.0012537732.35
3mitochondrial membrane (GO:0031966)4.573e-172.439e-16195310.007348319.17
4mitochondrial inner membrane (GO:0005743)7.582e-163.033e-15554.9819322.03
5organelle inner membrane (GO:0019866)1.232e-153.944e-15524.8618018.26

Hub genes predicted as biomarkers & predicted FDA approved drugs

Hub Genes (ranked)FDA-Approved Drugs
NDUFS3
NDUFA9
NDUFA2
NDUFC2
NDUFA6
NDUFA12
NDUFA1
NDUFA8
NDUFB10
NDUFB11