Cranial nerve involvement in COVID-19

Abstract

Introduction: The COVID-19 disease emerged in Wuhan province of China in November 2019 and spread across the world in a short time, resulting in a pandemic. The first case in Turkey was detected on March 11, 2020. The aim of the current study was to reveal the effects of COVID-19 on cranial nerves by monitoring people infected with the disease based on repeated examinations and surveys. Material and Method: The data of 356 patients with a positive COVID-19 polymerase chain reaction (PCR) test who received treatment between June 2020 and August 2020 in our hospital were prospectively evaluated after the study was approved by the relevant ethics committee. Results: Of the 356 patients included in the study, 47 under the age of 18 years were excluded due to their unreliable examination and anamnesis findings. In addition, seven patients that died while in hospital were excluded from the study due to the lack of examination and survey records during their hospitalization. The data of the remaining 302 patients were statistically analyzed. Symptoms of cranial nerve involvement were observed in 135 patients. Conclusion: The COVID-19 disease caused by the SARS-CoV2 virus commonly results in cranial nerve symptoms. The fact that these findings are more common and severe in COVID-19 than previous SARS and MERS outbreaks suggests that it has a more neurotrophic and more aggressive neuroinvasion. While the negative effects of the virus on sensory functions resulting from cranial nerve involvement are evident, motor functions are rarely affected.

Stridor Due to Cranial Nerve X Palsy Progressing to Polyneuropathy in a Teenager With COVID-19

“…While the tendency for SARS-CoV-2 to affect a variety of cranial nerves is now recognized, this patient's unusual presentation with stridor due to CN X palsy represents a previously undescribed neurological manifestation of COVID-19. While variants of GBS deserve consideration, a non-GBS polyneuritis is more likely and is consistent with other reports of COVID-19-associated cranial neuropathies [6,9]. This case, including her ultimately imprecise diagnosis, illustrates the lack of understanding of the pathogenic mechanisms of SARS-CoV-2 neurologic dysfunction.…”

“…Anosmia and dysgeusia are frequently recognized symptoms [1-5, 7, 8] and several other COVID-19-associated cranial neuropathies have been reported in the literature [6,[9][10][11][12][13][14][15][16][17][18][19][20][21].…”

Late peripheral facial paralysis after COVID-19: a rapid systematic review and two case reports

“…In the aforementioned two articles, the mean time between COVID-19 and PFP ranged from 7 to 12 days for three patients [47] and from 2 to 10 days in five patients [38]. In a study reporting 21 cases of nerve facialis [19], some patients presented associated diseases such as hypertension, diabetes mellitus, cardiac diseases, asthma, and Behçet's disease, but the study did not report the distribution of these diagnoses. One patient was empirically treated with doxycycline for suspected borreliosis [34].…”

“…Three papers described the occurrence of Bell's palsy in patients more than 30 days from their COVID-19 diagnosis [19,39,44]. Two articles were not included in the median calculation as they did not report this result.…”

Three Patients with Dysphagia Following Hospitalization and Respiratory Support for Severe COVID-19 Pneumonia

“…In regard to cognitive etiologies, critical illness is an important predictor of impaired swallowing reflex coordination [7]. This reflex may be further weakened in COVID-19 patients having incoordination between swallowing and respiration, and in whom central and peripheral nerve involvement is already proven [11][12][13]. According to recent findings, dysphagia in COVID-19 positive patients was thought to be related to the lack of the respiratory-swallowing coordination seen in ARDS or due to mechanical respiratory support damage [11].…”