Post-coronavirus disease 2019 polyneuropathy with significant response to immunoglobulin therapy: a case report

Abstract

Background The symptoms of coronavirus disease 2019, caused by the novel severe acute respiratory syndrome coronavirus 2, were originally assumed to be mainly respiratory. With increasing knowledge, however, it turned out that the spectrum of complaints varies broadly with age and concomitant diseases. While many neurological symptoms were reported in the context of the disease, ranging from permanent fatigue to recurrent headaches and concentration disturbance, treatment approaches are still in development. This case discusses a possible treatment approach with immunoglobulin therapy and its outcomes. Case presentation We present the case of a 56-year-old Caucasian female patient who, following coronavirus disease 2019, developed peripheral sensory and autonomic disturbances that fell within subacute demyelinating neuropathy. Because a significant improvement in symptoms as well as in the results of clinical and electrophysiological examination was reported after immunoglobulin therapy, long-term therapy does not appear to be necessary. Conclusion Given the significant subjective and objective improvement reported, this case provides additional evidence that immunoglobulin therapy can be considered in post-coronavirus disease 2019 syndrome.

A Scoping Review of Pharmacological Management of Postacute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in 2021

“…A total of 3524 records were found, with 52 included in the final analysis. 34–51,52–85 The numbers of records found per source and reasons for exclusion are described in Figure 1. A list of the included records is provided in Tables 2 and 3.…”

“…Twelve records were published in MEDLINE indexed journals with impact factors ranging from 0.477 to 25.071, 12 were published in a journal not indexed in MEDLINE, 1 was available on a preprint server, 1 was available only as an abstract, and 26 are clinical trials in progress. 34–51,52–85…”

“…52 Of the remaining 7 of the 26 records with published data, 4 examine various treatments for a myriad of general PASC symptoms, whereas 3 examine various treatments for specific symptoms. [53][54][55][56][57][58][59] For general PASC symptoms, 1 prospective, observational study reports general improvement with H1 and H2 receptor antagonists compared with untreated patients (72% symptom improvement vs. 26% symptoms improvement in treatment vs. control groups). 53 One survey reports general PASC symptom improvement after COVID-19 vaccine administration.…”

“…57 In addition, 1 case report demonstrates significant improvement in PASC-related polyneuropathy with immunoglobulin therapy. 58 Finally, 1 correspondence discusses low-dose aspirin for treatment of PASC-related acral cutaneous lesions. 59 Twenty-five of the 26 studies in progress are listed in clinicaltrials.gov.…”

Efficacy of intravenous immunoglobulin (IVIg) on COVID-19-related neurological disorders over the last 2 years: an up-to-date narrative review

“…Another case report by Saleh et al ( 2021 ) focused on a 56-year-old woman presenting with painful dysesthesia in the extremities after COVID-19. Over a few days, the patient developed a general weakness with walking disturbances.…”