Electrophysiological assessment in patients with COVID-19-related peripheral neuropathies and myopathies: a systematic review

Al-Mazidi, Sarah; Aldakhil, Lina Othman

doi:10.1152/jn.00386.2022

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…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 ]. However, these reports were based on case studies and series with major variations in patient selection criteria.…”

Section: Discussionsupporting

confidence: 94%

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

Al-Mazidi,

ALRouq,

Alsabty

et al. 2023

Cureus

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Background: The neurological effect of viral respiratory infections has been acknowledged in many studies. However, patients who recovered from this infection show neurological manifestations and are not being routinely transferred for electrodiagnostic evaluation. Aim: This study aimed to examine the neurological effect of viral respiratory infections on the nerve function using electrophysiology in patients fully recovered from viral respiratory infections. Methods: To limit bias in the results, the authors decided to choose patients who recovered from one virus in all participants (coronavirus). Medical records were screened for patients who performed nerve conduction studies (NCSs) before the coronavirus pandemic. Thirty patients met our inclusion criteria, and only 10 showed up to perform NCS. Data of the NCS was compared before and after the coronavirus infection for motor and sensory NCS parameters. Results: An increase in both the median and ulnar sensory nerve latencies and a decrease in the sensory nerve amplitude was observed. Also, there was a decrease in the motor conduction velocity (MCV) of the ulnar nerves and motor amplitude in the median nerve. In the lower limbs, there was a decrease in the sural nerve latency, increased MCV in the tibial nerves, and decreased MCV in the peroneal nerves. The proximal amplitudes of the tibial and peroneal nerves were increased, but the distal amplitude was increased only in the peroneal nerves and decreased in the tibial nerves. Conclusion: There is a significant impact of viral infections on the peripheral nerves. Large-scale prospective studies are required to investigate the pathogenesis of the neuropathy and myopathy after viral infections.

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Section: Discussionsupporting

confidence: 94%

“…Studies reported that most cases who underwent NCSs presented with myopathy, and a limited number of patients presented with polyneuropathy. As a result, motor NCS and electromyography (EMG) were abnormal in these patients compared to sensory NCS [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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

Al-Mazidi,

ALRouq,

Alsabty

et al. 2023

Cureus

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“…COVID-19 is associated with promoting radiculopathies ( 109 ), neuropathies ( 110 ), myopathies ( 111 ), and myasthenic syndromes ( 112 ). Here, when assessing the overall virus effect, we identified the production of the glial cell-derived neurotrophic factor (GDNF) and GDNF receptor alpha (GFRa1), which is a co-receptor in promoting GDNF neurite outgrowth and neuronal survival ( 49 ).…”

Section: Discussionmentioning

confidence: 99%

Anti-PD-L1 therapy altered inflammation but not survival in a lethal murine hepatitis virus-1 pneumonia model

Curran,

Cui,

et al. 2024

Front. Immunol.

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IntroductionBecause prior immune checkpoint inhibitor (ICI) therapy in cancer patients presenting with COVID-19 may affect outcomes, we investigated the beta-coronavirus, murine hepatitis virus (MHV)-1, in a lethal pneumonia model in the absence (Study 1) or presence of prior programmed cell death ligand-1 (PD-L1) antibody (PD-L1mAb) treatment (Study 2). MethodsIn Study 1, animals were inoculated intratracheally with MHV-1 or vehicle and evaluated at day 2, 5, and 10 after infection. In Study 2, uninfected or MHV-1-infected animals were pretreated intraperitoneally with control or PD-L1-blocking antibodies (PD-L1mAb) and evaluated at day 2 and 5 after infection. Each study examined survival, physiologic and histologic parameters, viral titers, lung immunophenotypes, and mediator production.ResultsStudy 1 results recapitulated the pathogenesis of COVID-19 and revealed increased cell surface expression of checkpoint molecules (PD-L1, PD-1), higher expression of the immune activation marker angiotensin converting enzyme (ACE), but reduced detection of the MHV-1 receptor CD66a on immune cells in the lung, liver, and spleen. In addition to reduced detection of PD-L1 on all immune cells assayed, PD-L1 blockade was associated with increased cell surface expression of PD-1 and ACE, decreased cell surface detection of CD66a, and improved oxygen saturation despite reduced blood glucose levels and increased signs of tissue hypoxia. In the lung, PD-L1mAb promoted S100A9 but inhibited ACE2 production concomitantly with pAKT activation and reduced FOXO1 levels. PD-L1mAb promoted interferon-γ but inhibited IL-5 and granulocyte-macrophage colony-stimulating factor (GM-CSF) production, contributing to reduced bronchoalveolar lavage levels of eosinophils and neutrophils. In the liver, PD-L1mAb increased viral clearance in association with increased macrophage and lymphocyte recruitment and liver injury. PD-L1mAb increased the production of virally induced mediators of injury, angiogenesis, and neuronal activity that may play role in COVID-19 and ICI-related neurotoxicity. PD-L1mAb did not affect survival in this murine model. DiscussionIn Study 1 and Study 2, ACE was upregulated and CD66a and ACE2 were downregulated by either MHV-1 or PD-L1mAb. CD66a is not only the MHV-1 receptor but also an identified immune checkpoint and a negative regulator of ACE. Crosstalk between CD66a and PD-L1 or ACE/ACE2 may provide insight into ICI therapies. These networks may also play role in the increased production of S100A9 and neurological mediators in response to MHV-1 and/or PD-L1mAb, which warrant further study. Overall, these findings support observational data suggesting that prior ICI treatment does not alter survival in patients presenting with COVID-19.

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“…Among these, seven individuals (4%) exhibited abnormal sensory NCS, while 44 (25.1%) displayed abnormal EMG findings, and 54 (30.8%) presented with abnormal motor NCS. The electrophysiological evaluations of the remaining patients were normal [6]. All of the studies included in this review reported that NCS findings, including sensory nerve conduction velocity (NCV), were not significantly altered in patients with COVID-19 relative to healthy controls.…”

Section: ) Electromyography and Nerve Conduction Studiesmentioning

confidence: 94%

Role of Electrodiagnostic Studies in COVID-19–Related Neuromuscular Disease: A Literature Review

Moon,

Kwon

2023

J Electrodiagn Neuromuscul Dis

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It is well-established that coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents with neurological symptoms. The understanding of its pathophysiology and its effects on the nervous system is continually evolving. Electrodiagnostic studies are commonly employed to characterize neurological symptoms and/or pinpoint the location of associated lesions. An increasing number of studies have documented immune responses to the SARS-CoV-2 vaccine and the effects of the virus on the nervous system. Our objective was to examine the existing clinical literature concerning neuromuscular diseases related to COVID-19, with the aim of correlating patient symptoms and characteristics with electrodiagnostic findings.

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Electrophysiological assessment in patients with COVID-19-related peripheral neuropathies and myopathies: a systematic review

Cited by 5 publications

References 33 publications

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

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

Anti-PD-L1 therapy altered inflammation but not survival in a lethal murine hepatitis virus-1 pneumonia model

Role of Electrodiagnostic Studies in COVID-19–Related Neuromuscular Disease: A Literature Review

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