Peripheral Neuropathy in Patients Recovering from Severe COVID-19: A Case Series

Balbi, Pietro; Saltalamacchia, Anna Maria; Lullo, F.; Fuschillo, Salvatore; Ambrosino, Pasquale; Moretta, Pasquale; Lanzillo, B.; Maniscalco, Mauro

doi:10.3390/medicina58040523

Cited by 6 publications

(3 citation statements)

References 39 publications

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“…These findings suggest that peripheral nervous system damage may be a common feature of MIS-C. Interestingly, both central and peripheral nervous system involvement in MIS-C have been previously described 49,50 , although these clinical manifestations are infrequent. Notably, peripheral nervous system damage has also been documented in pediatric and adult COVID-19 and in post-acute sequelae such as long COVID [51][52][53] . Future studies are needed to elucidate the mechanisms and clinical spectrum of neurologic involvement in acute MIS-C and their association with long-term neurodevelopment.…”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Nucleic acid biomarkers of immune response and cell and tissue damage in COVID-19 and MIS-C

Loy

Sotomayor-González

Servellita

et al. 2022

Preprint

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Differential host responses in coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C) remain poorly characterized. Here we use next-generation sequencing to longitudinally analyze blood samples from pediatric patients with acute COVID-19 (n=70) or MIS-C (n=141) across three hospitals. Profiling of plasma cell-free nucleic acids uncovers distinct signatures of cell injury and death between these two disease states, with increased heterogeneity and multi-organ involvement in MIS-C encompassing diverse cell types such as endothelial and neuronal Schwann cells. Whole blood RNA profiling reveals upregulation of similar pro-inflammatory signaling pathways in COVID-19 and MIS-C, but also MIS-C specific downregulation of T cell-associated pathways. Profiling of plasma cell-free RNA and whole blood RNA in paired samples yields different yet complementary signatures for each disease state. Our work provides a systems-level, multi-analyte view of immune responses and tissue damage in COVID-19 and MIS-C and informs the future development of new disease biomarkers.

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Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Nucleic acid biomarkers of immune response and cell and tissue damage in COVID-19 and MIS-C

Loy

Sotomayor-González

Servellita

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…In patients requiring intensive care, focal neurological deficits have been related to super-imposed mono-neuropathies of unknown etiology [ 36 ]; while in patients with diabetes, severe COVID-19 has been related to neuropathy symptoms and widespread sensory dysfunction [ 37 ]. In Italy, assessment of 102 convalescent patients who were admitted to a rehabilitation clinic showed electrophysiological abnormalities in 42.2% of patients, including peroneal mono-neuropathy in 8.8%, and multiple mono-neuropathy in 8.8% [ 38 ]. In this study, the majority of patients had moderate disease, and showed frequent peripheral neuropathy.…”

Section: Discussionmentioning

confidence: 99%

Body Weight May Have a Role on Neuropathy and Mobility after Moderate to Severe COVID-19: An Exploratory Study

et al. 2022

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Background and Objectives: Among the extra-pulmonary manifestations of COVID-19, neuromuscular signs and symptoms are frequent. We aimed to assess the correlation between neuromuscular abnormalities (electrophysiological) and mobility measures (Berg Balance Scale and Timed-Up-and-Go test) twice, at least 6 weeks after hospital discharge and 6 months later, taking into account cognitive performance, nutrition, muscle strength, and submaximal exercise capacity. Materials and Methods: 43 patients (51.4 ± 9.3 years old) accepted to participate in the study; they had a dyspnea score ≤ 3 (Borg scale), and no history of neurology/neuromuscular/orthopedic disorders, but high frequency of overweight/obesity and weight loss during hospital stay. The two evaluations included physical examination, cognitive assessment, nutritional evaluation, muscle strength (hand-grip and quadriceps dynamometry), electromyography, Barthel Index, Six-Minute- Walk-Test (6MWT), Berg Balance Scale and Timed-Up-and-Go test. Bivariate and repeated measures covariance analyses were performed (significance level of 0.05). Results: Electrophysiological abnormalities were evident in 67% of the patients, which were associated with diminished performance on the 6MWT, the Berg Balance Scale and the Timed-Up-and-Go test. At each evaluation and between evaluations, scores on the Berg Balance Scale were related to the body mass index (BMI) at hospital admission and the 6MWT (MANCoVA R ≥ 0.62, p = 0.0001), while the time to perform the Timed-Up-and-Go test was related to the electrophysiological abnormalities, weight loss during hospital stay, sex, handgrip strength, and the 6MWT (MANCoVA, R ≥ 0.62, p < 0.0001). We concluded that, after hospital discharge, patients with moderate to severe COVID-19 may have neuromuscular abnormalities that can be related to BMI/weight loss, and contribute to mobility decrease. In patients with moderate to severe COVID-19 and high BMI/ large weight loss, neuromuscular and intended mobility assessments could be required to provide early rehabilitation. Apart from the 6MWT, handgrip dynamometry and the Timed-Up-and-Go test were useful tools to quickly assess fitness and mobility.

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“…Both these mechanisms may apply in patients with deconditioning (23,24). Furthermore, reduced peripheral oxygen extraction has been shown in COVID-19 patients with small fibre neuropathy, complicating evaluation of exercise limitation even more (25,26).…”

Section: Exercise Capacity and Limitationsmentioning

confidence: 99%

Changes in cardiopulmonary exercise capacity and limitations 3–12 months after COVID-19

et al. 2022

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RationaleTo describe cardiopulmonary function during exercise 12 months after hospital discharge for COVID-19, assess the change from 3 to 12 months, and compare the results with matched controls without COVID-19.MethodsIn this prospective, longitudinal, multicentre cohort study, hospitalized COVID-19 patients were examined with a cardiopulmonary exercise test (CPET) 3 and 12 months after discharge. At 3 months 180 performed a successful CPET, and 177 at 12 months (mean age 59.3 years, 85 females). The COVID-19 patients were compared with controls without COVID-19 matched for age, sex, body mass index, and comorbidity. Main outcome was peak oxygen uptake (V′O2peak).ResultsExercise intolerance (V′O2peak <80% predicted) was observed in 23% at 12 months, related to circulatory (28%), ventilatory (17%), and other limitations including deconditioning, and dysfunctional breathing (55%). Estimated mean difference between 3 and 12 months showed significant increases in V′O2peak % predicted (5.0 percent points (pp), 95% CI (3.1 to 6.9), p<0.001), V′O2peak·kg−1% predicted (3.4 pp, (1.6 to 5.1), p<0.001), and oxygen pulse % predicted (4.6 pp, (2.5 to 6.8), p<0.001). V′O2peak was 2440 mL min−1 in COVID-19 patients compared to 2972 mL min−1 in matched controlsConclusionsOne year after hospital discharge for COVID-19, the majority, 77%, had normal exercise capacity. Only every fourth had exercise intolerance and in these circulatory limiting factors were more common than ventilatory. Deconditioning was common. V′O2peak and oxygen pulse improved significantly from 3 months.

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Peripheral Neuropathy in Patients Recovering from Severe COVID-19: A Case Series

Cited by 6 publications

References 39 publications

WITHDRAWN: Nucleic acid biomarkers of immune response and cell and tissue damage in COVID-19 and MIS-C

WITHDRAWN: Nucleic acid biomarkers of immune response and cell and tissue damage in COVID-19 and MIS-C

Body Weight May Have a Role on Neuropathy and Mobility after Moderate to Severe COVID-19: An Exploratory Study

Changes in cardiopulmonary exercise capacity and limitations 3–12 months after COVID-19

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