Mononeuritis multiplex: an unexpectedly frequent feature of severe COVID-19

Needham, Edward; Newcombe, Virginia; Michell, Andrew W.; Thornton, Rachel; Grainger, Andrew; Anwar, Fahim; Warburton, Elizabeth A.; Menon, David; Trivedi, Monica; Sawcer, Stephen

doi:10.1007/s00415-020-10321-8

Cited by 57 publications

(70 citation statements)

References 12 publications

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“…Altogether, 105 articles about SARS-CoV-2-associated neuropathy describing 220 patients with Guillain-Barré syndrome (GBS) 4 and 41 patients with non-GBS neuropathy were retrieved 5,6,7,8,9,10,11,12,13,14 . The age of these 261 patients, reported in 244 of them, ranged from 8 to 94 years.…”

Section: Resultsmentioning

confidence: 99%

Peripheral neuropathy in COVID-19 is due to immune-mechanisms, pre-existing risk factors, anti-viral drugs, or bedding in the Intensive Care Unit

Finsterer

Scorza

et al. 2021

Arq. Neuro-Psiquiatr.

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Background: This mini-review aims to summarize and discuss previous and recent advances in the clinical presentation, pathophysiology, diagnosis, treatment, and outcome of SARS-CoV-2-associated peripheral neuropathies. Methods: Literature review. Results: Altogether, 105 articles about SARS-CoV-2-associated neuropathy describing 261 patients were retrieved. Peripheral neuropathy in patients with COVID-19 is frequent and predominantly due to immune mechanisms or neurotoxic side effects of drugs used to treat the symptoms of COVID-19 and, to a lesser extent, due to the compression of peripheral nerves resulting from prolonged bedding in the Intensive Care Unit (ICU) and pre-existing risk factors such as diabetes. SARS-CoV-2 does not cause viral neuropathy. Neurotoxic drugs such as daptomycin, linezolid, lopinavir, ritonavir, hydro-chloroquine, cisatracurium, clindamycin, and glucocorticoids should be administered with caution and patients should be appropriately bedded in the ICU to prevent SARS-CoV-2-associated neuropathy. Patients with Guillain-Barré syndrome (GBS) benefit from immunoglobulins, plasma exchange, and steroids. Conclusions: Neuropathies of peripheral nerves in patients with COVID-19 are frequent and mostly result from immune mechanisms or neurotoxic side effects of drugs used to treat the symptoms of COVID-19 and, to a lesser extent, from the compression of peripheral nerves due to prolonged bedding on the ICU. SARS-CoV-2 does not cause infectious neuropathy.

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Section: Resultsmentioning

confidence: 99%

Peripheral neuropathy in COVID-19 is due to immune-mechanisms, pre-existing risk factors, anti-viral drugs, or bedding in the Intensive Care Unit

Finsterer

Scorza

et al. 2021

Arq. Neuro-Psiquiatr.

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“…It has been found in several post-COVID-19 follow-up cases that together with a global weakness related to loss of muscle mass, 16% of patients present with disabling focal neurological deficits relating to multiple axonal mononeuropathies [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Brain Disorders in Post Covid-19 Neurological Syndrome (PCNS) Patient

Nuzzo

Cambula²,

Bacile³

et al. 2021

Brain Sciences

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In the recent pandemic disease, called COVID-19, the role of neurologists and neurobiologists represents a chance to study key features of brain infection and deepen neurological manifestations of COVID-19 and other coronavirus infections. In fact, many studies suggest brain damage during infection and persistent neurological symptoms after COVID-19 infection. Reverse transcription PCR test, antibody tests, Magnetic Resonance of lung, and Computed Tomography of brain of the patient were periodically performed during this case report for eight months after infection. The aim of this article is to describe the prolonged neurological clinical consequences related to COVID-19. We believe it is clinically clear that we can define a post-acute COVID-19 neurological syndrome. Therefore, in patients after a severe clinical condition of COVID-19, a deepening of persistent neurological signs is necessary.

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“…Indeed, neuroimaging studies have commonly described cerebral microhaemorrhages occurring in those with severe COVID-19, reminiscent of microangiopathic disorders such as amyloid and hypertensive angiopathies [100,104,105], a phenomenon borne out in pathology series [32,75,100,106]. As would be expected in a disorder of the endothelium, similar microvascular changes have been described in multiple organ systems [107], and it has even been suggested that this process might be the cause of the mononeuritis multiplex seen in a substantial minority of survivors of severe COVID-19 [108].…”

Section: Neurovascular and Thromboembolic Diseasementioning

confidence: 91%

Neurological update: COVID-19

2021

Self Cite

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Coronavirus Disease 2019 is predominantly a disorder of the respiratory system, but neurological complications have been recognised since early in the pandemic. The major pathophysiological processes leading to neurological damage in COVID-19 are cerebrovascular disease, immunologically mediated neurological disorders and the detrimental effects of critical illness on the nervous system. It is still unclear whether direct invasion of the nervous system by the Severe Acute Respiratory Syndrome Coronavirus 2 occurs; given the vast numbers of people infected at this point, this uncertainty suggests that nervous system infection is unlikely to represent a significant issue if it occurs at all. In this review, we explore what has been learnt about the neurological complications of COVID-19 over the course of the pandemic, and by which mechanisms these complications most commonly occur.

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Mononeuritis multiplex: an unexpectedly frequent feature of severe COVID-19

Cited by 57 publications

References 12 publications

Peripheral neuropathy in COVID-19 is due to immune-mechanisms, pre-existing risk factors, anti-viral drugs, or bedding in the Intensive Care Unit

Peripheral neuropathy in COVID-19 is due to immune-mechanisms, pre-existing risk factors, anti-viral drugs, or bedding in the Intensive Care Unit

Long-Term Brain Disorders in Post Covid-19 Neurological Syndrome (PCNS) Patient

Neurological update: COVID-19

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