Ulnar Nerve Palsy as COVID-19 Sequelae in 3 Patients

Abstract

The pathophysiology and treatment of COVID-19 has been at the forefront of medical research this past year, and while great strides have been made in our knowledge of the disease, there is still much that is unknown. Greater than one third of patients with COVID-19 present with symptoms involving the nervous system. The reason for this is unclear, though several theories have been postulated. In this case study, we present three patients with severe ulnar nerve dysfunction following treatment for COVID-19 in the intensive care unit (ICU). We discuss reasons this may have occurred, the etiology of which is likely multifactorial. We are reporting these cases to inform and alert physicians to the possibility of ulnar nerve involvement in the presentation of patients with COVID-19.

Postoperative ulnar neuropathy: a systematic review of evidence with narrative synthesis

“… 9 Uncertain aetiology continues to typify this condition: a recent report of isolated ulnar neuropathies presenting after COVID-19 infection acknowledged this uncertainty and speculated that patient positioning during acute illness, the prothrombotic underlying disease process, direct virological effects, or immune-mediated nerve injury may have played a role in the genesis of the nerve injuries. 57 …”

Evaluation of radial nerve palsy treatment: tendon transfer with the flexor carpi radialis combination

“…4,5 Certain conditions such as COVID-19 have also been associated with nerve dysfunctions, including ulnar nerve palsy, which may have implications for radial nerve palsy. [6][7][8] Furthermore, certain chronic inflammatory diseases like rheumatoid arthritis can lead to extraarticular manifestations, potentially affecting peripheral nerves. 9 The impact of radial nerve palsy on daily life can be profound.…”