Clinical Features of Patients Referred to an Electroneurophysiology Laboratory After COVID-19 Infection: Retrospective Analysis

Abstract

The aim of this study was to determine the clinical features and electrophysiological diagnoses of patients referred to the electroneuromyography (ENMG) laboratory after coronavirus disease-2019 (COVID-19) infection. Material and Methods: Medical records of patients referred to the ENMG laboratory between March 11, 2020 and March 11, 2021 with neuromuscular signs and symptoms, preceded by a diagnosis of severe acute respiratory syndrome-CoV-2 (SARS-CoV-2), were reviewed retrospectively. Patient demographics, comorbidities, presenting complaints, date of SARS-CoV-2 infection, nature of electrophysiological investigation and ENMG outcomes were recorded. Results: A total of 1,274 medical records were reviewed, 62 patients were included in the study. Mean age was 50.39±17.2 years, 36 (58.1%) were male. The diagnosis of COVID-19 was made 7.29±1.59 months after the onset of the pandemic and 95.2% did not require treatment in the intensive care unit of the hospital. Patients presented with neuromuscular complaints 2.65±1.86 months after COVID-19 diagnosis. Common symptoms were paraesthesia (41.9%) and pain in the extremities (17.7%). Hypertension (22.6%) and diabetes mellitus (17.7%) were the most commonly reported comorbidities. Changes in sensation and deep tendon reflexes, and reduced muscle power were detected in 30.6%. Most common ENMG diagnosis was polyneuropathy (22.5%). ENMG findings were normal in 42.1%. Conclusion: COVID-19 gives rise to many neurological complications, including those involving the peripheral nervous system (PNS). Repeat ENMG and further, more sensitive electrophysiological testing should be considered in those with continued PNS complaints, despite initially normal electrophysiological findings. Further studies should establish whether SARS-CoV-2 infection is causal or coincidental in the development of PNS pathologies and related ENMG findings.