Nerve conduction study and electromyography findings in patients recovering from Covid-19 – Case report

Daia, Cristina; Scheau, Cristian; Neagu, Geanina; Andone, Ioana; Spanu, Aura; Popescu, Cristina; Stoica, Sergiu; Verenca, Madalina Codruta; Onose, Gelu

doi:10.1016/j.ijid.2020.11.146

Cited by 23 publications

(27 citation statements)

References 11 publications

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“…It is likely that CPK serum level sensitivity is lower in such a scenario. In line with our results, Daia et al have hypothesized a temporary myopathic injury without persistently elevated enzymes after SARS-Cov-2 infection [23].…”

Section: Discussionsupporting

confidence: 93%

Subclinical myopathic changes in COVID-19

et al. 2021

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Introduction Coronavirus disease 2019 (COVID-19) is associated to neuromuscular symptoms in up to 10.7% of hospitalized patients. Nevertheless, the extent of muscular involvement in infected subjects with no signs of myopathy has never been assessed with neurophysiological investigations. Methods Over a 3-week period — from April 30 through May 20, 2020 — a total of 70 patients were hospitalized in the Internal Medicine Ward of the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico in Milan, Italy. After excluding patients who underwent invasive ventilation and steroid treatment, 12 patients were evaluated. Nerve conduction studies (NCS) included the analysis of conduction velocity, amplitude, and latency for bilateral motor tibial, ulnar nerves, and sensory sural and radial nerves. Unilateral concentric-needle electromyography (EMG) was performed evaluating at least 4 areas of 8 selected muscles. For each muscle, spontaneous activity at rest, morphology, and recruitment of motor unit action potentials (MUAPs) were evaluated. Results While nerve conduction studies were unremarkable, needle electromyography showed myopathic changes in 6 out of 12 subjects. All patients were asymptomatic for muscular involvement. Clinical features and laboratory findings did not show relevant differences between patients with and without myopathic changes. Conclusion Our data show that in SARS-CoV-2 infection muscular involvement can occur despite the absence of clinical signs or symptoms and should be considered part of the disease spectrum. The application of muscle biopsy to unravel the mechanisms of myofiber damage on tissue specimens could help to clarify the pathogenesis and the treatment response of coronavirus-mediated injury. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-021-05469-8.

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Section: Discussionsupporting

confidence: 93%

Subclinical myopathic changes in COVID-19

et al. 2021

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“…One study has reported that the neurological symptoms preceded the respiratory symptoms [12]. However, some case reports and studies showed that neuropathy started after the respiratory symptoms started resolving as in our case [4,13,14]. Nonetheless, most of the cases with these symptoms of peripheral neuropathy had prolonged intensive care stay which was not present in our case [4,7].…”

Section: Discussioncontrasting

confidence: 50%

Lower limb axonal mononeuropathies as sequelae of COVID-19: a case report and review of literature

Mahmood

Mushtaq

Kanwar

2022

Egypt J Neurol Psychiatry Neurosurg

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Background Neurological symptoms and complications of Coronavirus disease 2019 (COVID-19) were seldom discussed in the literature initially. Neurological symptoms such as headache, dizziness, anosmia, hypogeusia, and neuralgia are, however, now being reported commonly. Mononeuropathies are rare complications of COVID-19, with most cases associated with prolonged intensive care stay. Case presentation A 61-year-old gentleman with prior history of well-controlled diabetes and hypertension was recently treated for COVID-19 pneumonia with supplemental oxygen and positive pressure ventilation. He now presented with left-sided foot weakness two weeks after recovering from the viral illness. On examination he had normal bulk and tone and a power of 4/5 in proximal and distal muscles of bilateral lower limbs except for ankle dorsiflexion on the left which was 2/5. He also had absent ankle and knee reflexes bilaterally with bilateral flexor plantar reflexes. Since the patient had no back pain and the sensory system was normal, the lesion was localized to the peripheral nerves and a Nerve Conduction Studies and Electromyography (NCS/EMG) was done. NCS/EMG showed findings suggestive of axonal mononeuropathies. Relevant workup done to identify the cause of mononeuropathy was negative including infectious and autoimmune workup. Since diabetes was well-controlled and he had no intensive care stay his findings were presumed to be associated with resolving COVID-19 infection. The patient underwent aggressive daily physical therapy and has started to show improvement in symptoms. Conclusions Complications such as mononeuropathies should be kept in mind in patients recovering from COVID-19 infection, since timely diagnosis can improve clinical outcomes in patients.

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“…This paper continues previous observations of our study group where using NCS we advanced the supposition that COVID-19 may cause polyneuropathy and myopathy. 9 …”

Section: Discussionmentioning

confidence: 99%

Motor demyelinating tibial neuropathy in COVID-19

Daia

Toader

Scheau

et al. 2021

Journal of the Formosan Medical Association

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Ten patients suffering from residual symptoms after the resolution of COVID-19, which manifested as fatigue in the lower limbs, have been submitted to nerve conduction studies. Motor demyelinating neuropathy features mainly of the tibial nerves but also the peroneal, median, and ulnar nerves were objectified. These findings might be considered as new neurological characteristics of SARS-CoV-2 infection.

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Nerve conduction study and electromyography findings in patients recovering from Covid-19 – Case report

Abstract: Highlights SARS-COV-2 may induce myopathy. SARS-COV-2 may induce demyelinating polyneuropathy. COVID-19 neuromusclar effects may be depicted by NCS and EMG.

Cited by 23 publications

References 11 publications

Subclinical myopathic changes in COVID-19

Subclinical myopathic changes in COVID-19

Lower limb axonal mononeuropathies as sequelae of COVID-19: a case report and review of literature

Motor demyelinating tibial neuropathy in COVID-19

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