Does the SARS-CoV-2 pandemic really increase the frequency of peripheral facial palsy?

Abstract

Purpose Publications about increased number of peripheral facial paralysis in the COVID-19 pandemic emerged in the literature. However, these studies comprised of an estimate rather than a broad analysis of exact numbers. In this study, we planned to investigate whether the pandemic really resulted in an increase in facial paralysis cases admitted to the hospital by evaluating the cases who applied to our hospital due to facial paralysis in the COVID-19 pandemic year and in the previous 4 years. Materials and methods Patients who applied to our hospital due to facial paralysis between March 2016–February 2017 (Group 1), between March 2017–February 2018 (Group 2), between March 2018–February 2019 (Group 3), between March 2019–February 2020 (Group 4), and between March 2020–February 2021 (Group 5) were investigated and detailed data were noted. Results 156, 164, 149, 172 and 157 patients were admitted to the hospital due to peripheral facial paralysis in Group 1, 2, 3, 4, and 5, respectively. Of these patients, 155, 164, 145, 169, and 153 were Bell's palsy, respectively. SARS-CoV-2 RT-PCR test was positive in only 2 of the 153 patients who were diagnosed in the year of the pandemic. Conclusions This study showed that the number of peripheral facial paralysis detected during the COVID-19 pandemic was similar to previous years. Very few number of positive SARS-CoV-2 RT-PCR test results may have been found incidentally in Bell's palsy patients. Theses stating that SARS-CoV-2 causes peripheral facial paralysis should be supported by laboratory studies and postmortem research.

Data from 235 Cases of Bell’s Palsy during COVID-19 Pandemic: Were There Clusters of Facial Palsy?

“…As interesting data, 7 patients were tested for SARS-CoV-2 by PCR in nasal swab during the BP in 2020, and only 2 resulted positive. This low rate of detection of SARS-CoV-2 viral genome among BP patients coincides with other case-series reported [ 3 ]. Finally, we explored the possibility of clusters of BP around the “peaks” of CO­VID-19 pandemic based on data from the Health Ministry of Spain over the 14-day Accumulated Incidence of COVID-19-positive cases per 100,000 inhabitants [ 6 ].…”

“…Different clinical series on the prevalence of Bell's palsy (BP) in the pandemic are emerging in the literature. Some researchers [ 1 , 2 ] suggest a link between facial palsy and SARS-CoV-2, although other authors [ 3 ] do not find significant differences in the incidence of facial palsy, with low rate of detection of SARS-CoV-2 viral genome in nasal swab coinciding with paralysis (2/153 BP cases). After a year of the COVID-19 pandemic, attributing to the SARS-CoV-2 virus an increase of incidence of BP cases remains unclear [ 4 ].…”

The Validity of the Spesi Score in Mortality Prediction at Four-Year Follow-Up of Patients With Pulmonary Embolism and Aged Over 65 Years

“…Our research showed that the frequency of admission to the emergency department with facial paralysis among geriatric patients increased significantly during the Covid-19 pandemic. Previous studies have reported an increased incidence of facial paralysis in Covid-19 patients, but there are different opinions about the increased risk in the normal population (9)(10)(11)(12). A study conducted in Italy similarly found an increase in the frequency of admission to the emergency department due to facial paralysis during the pandemic compared to the same period of the previous year (11).…”

Disorders of cranial and spinal nerves

“…There has been an increase in the number of reports in the literature of rectly linked or just coincidental is still a matter of debate. While some Authors suggest a higher occurrence of facial palsy during the COVID-19 outbreak, tious disorders [71][72][73] .…”