Increased Cases of Acute Polyneuropathy in COVID-19 Pandemic: What Awaits Neurologists?

Abstract

Introduction:Severe acute respiratory syndrome coronavirus 2 infection 2019 primarily affects the respiratory system but central and peripheral neurological manifestations have been increasingly recognized and reported. Materials and methods:The study consisted of patients with acute polyneuropathy that developed after the Covid-19 infection. All patients were confirmed serologically for PCR positivity and typical ground glass appearance in thorax tomography in case of respiratory involvement. In 16 patients, polyneuropathy was diagnosed with an electrophysiological and neurological examination. Etiological research was conducted for all patients to exclude any other causes of acute polyneuropathy. Results:The average age of the patients was 64.3 (29-83) years; most cases were female (13 vs. 3). The interval between the onset of symptoms of Covid-19 and the first symptoms of acute polyneuropathy ranged from 11 to 63 (Mean: 21.5) days. The initial symptoms of acute polyneuropathy were lower-limb weakness and paraesthesia in 11 patients whereas generalized, flaccid tetraparesis was detected in 3 patients. Except for pure sensory symptoms, no motor findings were detected in the two patients. On electroneuromyography (ENMG), there was AMSAN in 7 patients; 7 patients had AMAN and 2 patients had AIDP findings. Five patients accepted lumbar puncture; on analysis of the CSF, one patient had normal protein level and the others showed an albumino-cytological dissociation, increased protein in the cerebrospinal fluid without increase in cell count, characteristic of the GBS. Conclusion:Awareness of the possible causal association between acute polyneuropathy and Covid-19, recommends long-term follow-up of Covid-19 patients for neurologic complications.