Peripheral Neuropathy as a Complication of SARS-Cov-2

Bureau, Britta L.; Obeidat, Ahmed Z.; Dhariwal, Mohan S; Jha, Pinky

doi:10.7759/cureus.11452

Cited by 26 publications

(31 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Altogether, 105 articles about SARS-CoV-2-associated neuropathy describing 220 patients with Guillain-Barré syndrome (GBS) 4 and 41 patients with non-GBS neuropathy were retrieved 5,6,7,8,9,10,11,12,13,14 . The age of these 261 patients, reported in 244 of them, ranged from 8 to 94 years.…”

Section: Resultsmentioning

confidence: 99%

Peripheral neuropathy in COVID-19 is due to immune-mechanisms, pre-existing risk factors, anti-viral drugs, or bedding in the Intensive Care Unit

Finsterer

Scorza

et al. 2021

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Background: This mini-review aims to summarize and discuss previous and recent advances in the clinical presentation, pathophysiology, diagnosis, treatment, and outcome of SARS-CoV-2-associated peripheral neuropathies. Methods: Literature review. Results: Altogether, 105 articles about SARS-CoV-2-associated neuropathy describing 261 patients were retrieved. Peripheral neuropathy in patients with COVID-19 is frequent and predominantly due to immune mechanisms or neurotoxic side effects of drugs used to treat the symptoms of COVID-19 and, to a lesser extent, due to the compression of peripheral nerves resulting from prolonged bedding in the Intensive Care Unit (ICU) and pre-existing risk factors such as diabetes. SARS-CoV-2 does not cause viral neuropathy. Neurotoxic drugs such as daptomycin, linezolid, lopinavir, ritonavir, hydro-chloroquine, cisatracurium, clindamycin, and glucocorticoids should be administered with caution and patients should be appropriately bedded in the ICU to prevent SARS-CoV-2-associated neuropathy. Patients with Guillain-Barré syndrome (GBS) benefit from immunoglobulins, plasma exchange, and steroids. Conclusions: Neuropathies of peripheral nerves in patients with COVID-19 are frequent and mostly result from immune mechanisms or neurotoxic side effects of drugs used to treat the symptoms of COVID-19 and, to a lesser extent, from the compression of peripheral nerves due to prolonged bedding on the ICU. SARS-CoV-2 does not cause infectious neuropathy.

show abstract

Section: Resultsmentioning

confidence: 99%

Peripheral neuropathy in COVID-19 is due to immune-mechanisms, pre-existing risk factors, anti-viral drugs, or bedding in the Intensive Care Unit

Finsterer

Scorza

et al. 2021

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…Though, the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-COV2 virus) among human beings has been believed to be via close contact (droplets) or distant (aerosol particles), contaminated surfaces, or fecal transmission [7], the exact mechanism of nervous system involvement is still unknown [6]. However, the possible routes of transmission could be retrograde neuronal transport across infected neurons, entry via the olfactory nerve, infection of the vascular endothelium, leucocytes migration across the blood-brain barrier, or via angiotensin-converting enzyme-2 receptors found on neurons and glial cells [8].…”

Section: Discussionmentioning

confidence: 99%

“…However, COVID-19-induced peripheral neuropathy has been rarely reported [4,5]. With the course of time, there have been an increasing concerns about COVID-19-induced neuropathy whose pathophysiology is yet to be understood [6]. Here, we present a case of a 34-year-old female with COVID-19-induced unilateral sciatic neuropathy requiring prolonged physical medicine and rehabilitation stay.…”

Section: Introductionmentioning

confidence: 94%

COVID-19-Induced Left Sciatic Neuropathy Requiring Prolonged Physical Medicine and Rehabilitation

Acharya¹,

Thibault²,

Lee³

et al. 2021

Cureus

View full text Add to dashboard Cite

A growing number of case reports and series have described a wide spectrum of neurological manifestations of COVID-19 disease including encephalopathy, cerebrovascular disease, and Guillain-Barre syndrome (GBS). However, peripheral neuropathy associated with COVID-19 disease has been uncommonly reported.Here, we describe a young patient with a COVID-19 infection who developed unilateral sciatic neuropathy during the course of treatment requiring prolonged physical medicine and rehabilitation stay. She was treated in the intensive care unit (ICU) for hypoxic respiratory failure for 22 days total, during which she was intubated, sedated, and paralyzed for 14 days. She received dexamethasone, convalescent plasma, and remdesivir for COVID-19; she also received ceftriaxone and azithromycin for possible superimposed bacterial pneumonia. The hypoxic respiratory failure was improved progressively, and she was extubated. On day 17 of ICU stay, she reported numbness and weakness in left leg and had 0/5 motor strength at the left ankle in all directions. She was able to move left hip and knee and had decreased sensation to light touch and pain from the level of the left knee to the toes. Imaging of the brain and spine showed no obvious findings that would explain the neurological symptoms. On electromyography (EMG), there was acute denervation in the left tibialis anterior muscle. She required prolonged physical medicine and rehabilitation care, greater than 60 days during which she had some improvement in sensation, but remained without ankle movement for two more months. This could be a rare manifestation of COVID-19-induced sciatic mono-neuropathy given her symptoms, EMG reports, clinical exam, and normal imaging studies.

show abstract

“…The spectrum of neuropathies is broad and strongly overlaps with neuropathological features that have also been demonstrated in clinical studies. Neuropathies are particularly common in severe cases [ 66 ]. Damage to peripheral nerves in the form of Miller–Fisher syndrome occurs frequently as a result of the cytokine storm and as antibody-mediated neuropathy [ 67 ].…”

Section: Manifestationsmentioning

confidence: 99%

Neuropsychiatric Disorders and COVID-19: What We Know So Far

et al. 2021

View full text Add to dashboard Cite

SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) affects the central nervous system (CNS), which is shown in a significant number of patients with neurological events. In this study, an updated literature review was carried out regarding neurological disorders in COVID-19. Neurological symptoms are more common in patients with severe infection according to their respiratory status and divided into three categories: (1) CNS manifestations; (2) cranial and peripheral nervous system manifestations; and (3) skeletal muscle injury manifestations. Patients with pre-existing cerebrovascular disease are at a higher risk of admission to the intensive care unit (ICU) and mortality. The neurological manifestations associated with COVID-19 are of great importance, but when life-threatening abnormal vital signs occur in severely ill COVID-19 patients, neurological problems are usually not considered. It is crucial to search for new treatments for brain damage, as well as for alternative therapies that recover the damaged brain and reduce the inflammatory response and its consequences for other organs. In addition, there is a need to diagnose these manifestations as early as possible to limit long-term consequences. Therefore, much research is needed to explain the involvement of SARS-CoV-2 causing these neurological symptoms because scientists know zero about it.

show abstract

Peripheral Neuropathy as a Complication of SARS-Cov-2

Cited by 26 publications

References 12 publications

Peripheral neuropathy in COVID-19 is due to immune-mechanisms, pre-existing risk factors, anti-viral drugs, or bedding in the Intensive Care Unit

Peripheral neuropathy in COVID-19 is due to immune-mechanisms, pre-existing risk factors, anti-viral drugs, or bedding in the Intensive Care Unit

COVID-19-Induced Left Sciatic Neuropathy Requiring Prolonged Physical Medicine and Rehabilitation

Neuropsychiatric Disorders and COVID-19: What We Know So Far

Contact Info

Product

Resources

About