COVID 19 infection presenting as motor peripheral neuropathy

Abdelnour, Loay H; Abdalla, Mohammed; Babiker, Saleem

doi:10.1016/j.jfma.2020.04.024

Cited by 67 publications

(75 citation statements)

References 2 publications

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“…In addition to GBS and MFS, we also included three reports of six patients who developed symmetrical or asymmetrical neuropathy (Table 5) [66][67][68].…”

Section: Search Resultsmentioning

confidence: 99%

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Neuromuscular presentations in patients with COVID-19

et al. 2020

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COVID-19 is caused by the coronavirus SARS-CoV-2 that has an affinity for neural tissue. There are reports of encephalitis, encephalopathy, cranial neuropathy, Guillain-Barrè syndrome, and myositis/rhabdomyolysis in patients with COVID-19. In this review, we focused on the neuromuscular manifestations of SARS-CoV-2 infection. We analyzed all published reports on SARS-CoV-2-related peripheral nerve, neuromuscular junction, muscle, and cranial nerve disorders. Olfactory and gustatory dysfunction is now accepted as an early manifestation of COVID-19 infection. Inflammation, edema, and axonal damage of olfactory bulb have been shown in autopsy of patients who died of COVID-19. Olfactory pathway is suggested as a portal of entry of SARS-CoV-2 in the brain. Similar to involvement of olfactory bulb, isolated oculomotor, trochlear and facial nerve has been described. Increasing reports Guillain-Barrè syndrome secondary to COVID-19 are being published. Unlike typical GBS, most of COVID-19-related GBS were elderly, had concomitant pneumonia or ARDS, more prevalent demyelinating neuropathy, and relatively poor outcome. Myalgia is described among the common symptoms of COVID-19 after fever, cough, and sore throat. Duration of myalgia may be related to the severity of COVID-19 disease. Few patients had muscle weakness and elevated creatine kinase along with elevated levels of acute-phase reactants. All these patients with myositis/rhabdomyolysis had severe respiratory complications related to COVID-19. A handful of patients with myasthenia gravis showed exacerbation of their disease after acquiring COVID-19 disease. Most of these patients recovered with either intravenous immunoglobulins or steroids.

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“…In addition to GBS and MFS, we also included three reports of six patients who developed symmetrical or asymmetrical neuropathy (Table 5) [66][67][68].…”

Section: Search Resultsmentioning

confidence: 99%

“…Three reports of 6 patients with COVID-19-related neuropathy were published [66][67][68]. Authors claimed that the neuropathy in their patients was different from GBS.…”

Section: Neuropathymentioning

confidence: 99%

Neuromuscular presentations in patients with COVID-19

et al. 2020

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“…Other types of polyneuropathy were also reported with SARS-CoV, MERS-CoV, and COVID-19 [24,85,[103][104][105][106]. In SARS-CoV, a prospective case series from Taiwan reported four patients who developed neuromuscular symptoms mainly consistent with either critical illness polyneuropathy (CIP) or a myopathy with elevated creatinine kinase [103].…”

Section: Neuromuscular Disordersmentioning

confidence: 95%

Neurological Complications of SARS-CoV, MERS-CoV, and COVID-19

Alshebri

Alshouimi

Alhumidi

et al. 2020

SN Compr. Clin. Med.

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This review provides an overview of studies and case reports of neurological and neuromuscular complications associated with severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and coronavirus disease 2019 (COVID-19) and describes the possible mechanisms of viral transmission to the central nervous system (CNS). Coronavirus family has shown central and peripheral nervous system tropism in multiple retrospective studies and case reports from different parts of the world. To date, the reported cases of neurological and neuromuscular complications associated with coronaviruses, especially COVID-19, are increasing. Neurological and neuromuscular symptoms and complications ranging from headache and anosmia to more severe encephalitis and stroke have been reported in many studies. However, the neurotropism mechanism of coronaviruses is still not clear and the evidence of central nervous system (CNS) involvement is limited despite the number of studies that attempted to illustrate the possible CNS invasion mechanisms. The reported neurological complications of coronaviruses are summarized in this article. Keywords Neurological complications. COVID-19. SARS. MERS. Encephalopathy. Stroke strains of coronavirus have been identified as human pathogens [2]. These include HCoV-229E, HCoV-OC43, HCoV-HKU1, HCoV-NL63, severe acute respiratory syndrome CoV (SARS-CoV), Middle East respiratory syndrome, and more recently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coronaviruses are mainly respiratory pathogens that cause a wide range of upper and lower respiratory tract infections with various neurological complications that will be highlighted in this review paper. Understanding the virological background of these different viral infections might facilitate learners' perception of the disease's prognosis and management. SARS-CoV is an acute respiratory infection that was first reported in November 2002 in Guangdong Province [3]. It spread to other regions in America, Asia, and Europe in late 2003, infecting about 8000 people worldwide, with a mortality rate of 10%. By June 2012, a new strain of coronavirus called the Middle East respiratory syndrome coronavirus (MERS-CoV) emerged from Jeddah, Saudi Arabia [4]. MERS-CoV seems to have originated from bats and infected the intermediary reservoir (the dromedary camel) before being transmitted to humans [2]. Similarly to SARS-CoV, MERS-CoV causes severe respiratory infections that are complicated by multiorgan failure and death in some patients [2]. At the end of January 2020, a total of 2519 cases had been identified worldwide, This article is part of the Topical Collection on Covid-19

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“…Among the 68 studies on the CNS effects, 46 were case reports [16,17,, followed by 10 retrospective studies [64][65][66][67][68][69][70][71][72][73], 4 observational cohort studies [74][75][76][77], 3 prospective studies [78][79][80], 3 case-control studies [81][82][83] and 2 cross-sectional studies [84,85]. Among the 21 studies regarding PNS disorders, there were 19 case reports [86][87][88][89][90][91][92][93][94][95][96][97][98][99][100][101][102][103][104], 1 prospective study [78] and 1 retrospective study [68]. Two studies reported both CNS and PNS effects of COVID-19 [68,78].…”

Section: Categorization and Characteristics Of The Selected Studiesmentioning

confidence: 99%

“…Abdelnour and colleagues [86] reported the case of a 69-year-old man exhibiting numbness on both legs and reduced muscular power as secondary symptoms of SARS-CoV-2 infection. The patient had a past medical history of hypertension, diabetes mellitus and chronic obstructive pulmonary disease.…”

Section: Effects Of Sars-cov-2 On Pnsmentioning

confidence: 99%

Neurological Complications of COVID-19 and Possible Neuroinvasion Pathways: A Systematic Review

Orrù

Conversano

Malloggi

et al. 2020

IJERPH

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The Coronavirus Disease 2019 (COVID-19) outbreak has shocked the whole world with its unexpected rapid spread. The virus responsible for the disease, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), enters host cells by means of the envelope spike protein, which binds to angiotensin-converting enzyme 2 receptors. These receptors are highly expressed in heart, lungs, respiratory tract epithelium, endothelial cells and brain. Since an increasing body of significant evidence is highlighting a possible neuroinvasion related to SARS-CoV-2, a state of the art on the neurological complications is needed. To identify suitable publications, our systematic review was carried out by searching relevant studies on PubMed and Scopus databases. We included studies investigating neurologic manifestations of SARS-CoV-2 in patients over 18. According to the analyzed studies, the most frequent disorders affecting central nervous system (CNS) seem to be the following: olfactory and taste disorders, ischemic/hemorrhagic stroke, meningoencephalitis and encephalopathy, including acute necrotizing encephalopathy, a rare type of encephalopathy. As regards the peripheral nervous system (PNS), Guillain-Barré and Miller Fisher syndromes are the most frequent manifestations reported in the literature. Important clinical information on the neurological manifestations of SARS-CoV-2 would help clinicians raise awareness and simultaneously improve the prognosis of critically ill patients.

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COVID 19 infection presenting as motor peripheral neuropathy

Cited by 67 publications

References 2 publications

Neuromuscular presentations in patients with COVID-19

Neuromuscular presentations in patients with COVID-19

Neurological Complications of SARS-CoV, MERS-CoV, and COVID-19

Neurological Complications of COVID-19 and Possible Neuroinvasion Pathways: A Systematic Review

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