Short-term evaluation of motor and sensory nerve conduction parameters in COVID-19-associated peripheral neuropathy patients

Abstract

Background Severe acute respiratory syndrome coronavirus 2 (SARS‐COV‐2) is mostly associated with upper and lower respiratory tract manifestations. However, coronavirus disease 19 (COVID-19) can result in a wide range of other systemic symptomatology, including neuropsychiatric, psychological, and psychosocial impairments. Literature regarding neurological compromise, including neuropathy and sensory and motor affection associated with COVID-19, is still limited. This study aims to evaluate the sensory, motor neuropathy, and secondary neurological impairment among patients with mild to moderate coronavirus disease associated with peripheral neuropathy within 1 month. Methods Forty participants, including 20 mild to moderate COVID-19 patients with peripheral neuropathy and 20 age and gender-matched healthy volunteers, were recruited in this case/control study. Laboratory evaluation focused on C-reactive protein (CRP) and D-dimer levels. Oxygen saturation for all participants was recorded. The neurophysiological study included motor nerve study, sensory nerve study, and F wave study for upper and lower limbs were done. Results The two groups were similar regarding baseline data. Neurological symptoms’ onset in the COVID-19 group ranged from 4 to 24 days. Levels of CRP and D-dimer levels were significantly higher in patients versus the control group. Motor nerve conduction (MNC) amplitude and latency for the median nerve were significantly compromised among the COVID-19 group. The MNC latency and F wave latency for the posterior tibial nerve were significantly higher in the COVID-19 group. The CRP and D-dimer levels were associated with a significant positive correlation with a latency of median nerve MNC, sensory nerve conduction (SNC), and f-wave; latency of MNC and F wave of the posterior tibial nerve; and SNC latency for sural nerve. Conclusion neurological involvement can occur in mild to moderate cases of SARS-COV-2 infection and add to the burden of the disease. Neurological symptoms in the course of COVID-19 disease should be interpreted cautiously, and appropriate diagnosis, including nerve conduction studies and management, should be considered. Trial registration ClinicalTrials.gov. NCT05721040.

Response to editor’s letter

“…I am writing this letter in response to the letter to the editor submitted to the Egyptian Journal of Bronchology with an inquiry on my recently published paper in your reputable journal under the title “Short-term Evaluation of motor and sensory nerve conduction parameters in COVID-19-associated peripheral neuropathy patients” [ 1 ].…”

Short-term evaluation of motor and sensory nerve conduction parameters in COVID-19-associated peripheral neuropathy patients

“…On using motor and nerve conduction studies, Shaddad et al [ 1 ] found that motor nerve conduction (MNC) latency and amplitude for the median nerve (MN) were deranged significantly in COVID-19 patients. The COVID-19 patients also had significantly greater MNC latency and F wave latency for the posterior tibial nerve (PTN).…”

“…The COVID-19 patients also had significantly greater MNC latency and F wave latency for the posterior tibial nerve (PTN). The D-dimer and C-reactive protein levels were correlated with a significant positive association with a latency of MN MNC, sensory nerve conduction (SNC), and f-wave; latency of MNC and F wave of the PTN; and SNC latency for sural nerve [ 1 ]. In addition to the study limitation of the lack of long-term follow-up which was addressed by Shaddad et al [ 1 ], we, hereby, explore the following limitation.…”

“…The D-dimer and C-reactive protein levels were correlated with a significant positive association with a latency of MN MNC, sensory nerve conduction (SNC), and f-wave; latency of MNC and F wave of the PTN; and SNC latency for sural nerve [ 1 ]. In addition to the study limitation of the lack of long-term follow-up which was addressed by Shaddad et al [ 1 ], we, hereby, explore the following limitation. Neurophysiological studies, which involve various components, are crucial tools for the investigation of neuromuscular diseases.…”

“…Interestingly, Egypt has developed its own RV for these studies [ 6 ]. In the study methodology, Shaddad et al [ 1 ] stated that the values below the 95 th centile or ± 2SD of control for all components of neurophysiological studies were regarded as abnormal. However, they didn’t address the reference of the employed RV.…”