Focal Peripheral Neuropathies Observed in Patients Diagnosed With COVID-19

Abstract

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The COVID‐19 pandemic and its consequences for chronic pain: a narrative review

“…Exposure to mechanical ventilation, neuromuscular blockers and steroids leads to increased risk of developing acute respiratory distress syndrome, myopathy and post‐traumatic stress disorder [ 9 ]. Prone positioning as a ventilation strategy has been reported to add additional risk of peripheral nerve injury with possible weakness and subsequent pain [ 31 , 32 ]. Early in the pandemic, among 100 patients treated in the ICU, pain was the sixth most common symptom at 48 days after discharge [ 33 ].…”

“…Myopathy can be induced by medications and immobility. Positioning for prone ventilation can lead to peripheral nerve and other injuries [ 31 , 32 ]. Similarly, the known increased incidence of stroke in COVID‐19 patients could contribute to higher burden of post‐stroke pain in survivors [ 53 ].…”

Acquired peripheral nerve injuries associated with severe COVID-19

“…Malik et al described a case series of COVID-19 PNIs in 12 patients admitted to an inpatient rehabilitation 8 , which has subsequently been reaffirmed by several other published case series in survivors of severe COVID-19. 9-13 The anatomical distribution of PNIs implies a role for mechanical forces as these localizations mirror sites known to be vulnerable to compression and/or traction. 6, 7…”

“…Malik et al described a case series of COVID-19 PNIs in 12 patients admitted to an inpatient rehabilitation 8 , which has subsequently been reaffirmed by several other published case series in survivors of severe COVID-19. [9][10][11][12][13] The anatomical distribution of PNIs implies a role for mechanical forces as these localizations mirror sites known to be vulnerable to compression and/or traction. 6,7 Unfortunately, the recovery from PNI is notoriously slow and frequently incomplete in the general population 14 , and the demographics of severe COVID-19 patients include enrichment of known risk factors for worse outcomes after PNI such as advanced age, obesity and diabetes mellitus.…”

“…8,9 Here we use a retrospective chart review to define the types and distribution of PNIs in survivors of severe COVID-19, which is integrated with several smaller published case series. [8][9][10][11][12][13] Additionally, we provide feasibility data on a wearable, wireless pressure sensor to provide real time monitoring at the elbow, which has been the single most common nerve compression site in COVID-19 survivors.…”