Small fiber neuropathy in a patient with coronavirus disease 2019 (COVID-19)

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel beta-coronavirus that causes a variety of symptoms in patients known as coronavirus disease (COVID-19). COVID-19 infection may cause complications involving the central nervous system (CNS), peripheral nervous system (PNS), muscles, or autonomic system (ANS). Compared with central and peripheral nervous system involvement in COVID-19 infection reports, the bibliography describing ANS manifestations is more limited. We report a patient with confirmed SARS-CoV-2, admitted to one of the tertiary hospitals in Singapore with small fiber neuropathy. Small fiber neuropathy as a neurological manifestation in COVID-19 infection is rare. Our case report adds to and supports this observation and also highlights how SFN in COVID-19 infection can be self-limited without requiring immunosuppressive treatment.

Small Fiber Neuropathy Triggered by COVID-19 Vaccination: Association with FGFR3 Autoantibodies and Improvement during Intravenous Immunoglobulin Treatment

“…There is strong epidemiological data suggesting that COVID vaccination can cause neuropathies such as Guillain-Barre syndrome [6]. Small fiber neuropathy, unlike Guillain-Barre syndrome and chronic inflammatory polyneuropathy, is not an established post-inflammatory or autoimmune condition [12] nor is it an FDA-approved condition for IVIG. This is particularly relevant since many patients have suffered with idiopathic small fiber neuropathies and can only be treated palliatively with non-narcotic nerve pain medication.…”