Post-COVID symptoms of potential peripheral nervous and muscular origin

Abstract

Many patients report persistent symptoms attributable to dysfunction of the peripheral nervous and muscular systems after acute COVID-19. These symptoms may constitute part of the so-called post–acute COVID-19 syndrome (PACS), or may result from neuromuscular complications of hospitalisation in intensive care units (ICUs). This article provides an updated review of symptoms of potential neuromuscular origin in patients with PACS, differentiating symptoms according to muscle, peripheral nerve, or autonomic nervous system involvement, and analyses the forms of neuromuscular involvement in patients who were admitted to the ICU due to severe COVID-19.

Relationship Between Clinical Outcomes and Nerve Conduction Studies Before and After Viral Infections in Healthy Individuals: Case Series

“…The neurological effect of viral infections has been reported resulting in myopathy and central and peripheral neuropathies. Studies on the peripheral impact of coronavirus infections mainly reported neuropathy of muscular origin, but others reported that it also affected the peripheral nerves resulting in peripheral neuropathy [ 12 ]. Our results showed that both sensory and motor parameters were affected.…”

“…Previous studies also showed normal values of sensory NCS with minor changes observed in the motor NCS in coronavirus patients suggesting a myopathy rather than sensory neuropathy [ 17 , 18 ]. These findings were also affected by hospitalization and the severity of the disease, which might develop later after recovery [ 12 , 19 ].…”

“…Electrodiagnostic studies are not routinely performed in coronavirus patients with neurological symptoms [ 12 ]. Previous studies mainly reported a normal NCS in coronavirus patients, which is in agreement with our results [ 7 ].…”

Long COVID, the Brain, Nerves, and Cognitive Function

“…Sensorimotor symptoms of COVID-19 can take a number of forms, including peripheral neuropathy, paresthesias, neuropathic pain, myalgia, and persistent weakness [ 130 , 131 , 132 , 133 ] ( Figure 2 ). Pilotto et al found that, at the 6 month follow-up appointment, 40% of previously hospitalized COVID-19 patients had neurologic deficits and that 7.6% of these survivors had subtle motor or sensory deficits [ 134 ].…”

“…Neuropathy resulting from COVID-19 may be falsely attributed to the state of critical illness seen in some severe acute infections or to compression and traction from prolonged immobility [ 154 ]. The treatment options for neuropathy related to COVID-19 are those used for inflammatory neuropathy: Intravenous immunoglobulin (IVIG) and/or corticosteroids [ 130 , 131 , 155 ]. A short course of steroids is a relatively safe empirical option [ 156 ].…”