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

ABSTRACT 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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Pressure ulcers in the adult intensive care unit: a literature review of patient risk factors and risk assessment scales

Journal of Nursing Education and Practice ◽

10.5430/jnep.v3n11p28 ◽

2013 ◽

Vol 3 (11) ◽

Cited By ~ 11

Author(s):

Nahla Tayyib ◽

Fiona Coyer ◽

Peter Lewis

Keyword(s):

Risk Factors ◽

Risk Assessment ◽

Intensive Care Unit ◽

Intensive Care ◽

Literature Review ◽

Pressure Ulcers ◽

Patient Risk ◽

Adult Intensive Care Unit ◽

Assessment Scales

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Rare cutaneous manifestation of COVID-19

BMJ Case Reports ◽

10.1136/bcr-2020-240863 ◽

2021 ◽

Vol 14 (1) ◽

pp. e240863

Author(s):

Lisa Killion ◽

Paula Evelyn Beatty ◽

Asad Salim

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Neuropathic Pain ◽

Intensive Care ◽

Peripheral Neuropathy ◽

Disease Burden ◽

Ventilatory Support ◽

Cutaneous Manifestations ◽

History Of ◽

Inflammatory Syndrome

The COVID-19 pandemic has resulted in an incomparable disease burden worldwide. One of the main contributors stems from the multisystem inflammatory syndrome associated with SARS-CoV-2 infection. The numbers of those affected continue to rise with the increasing number of confirmed COVID-19 cases. However, we are yet to fully comprehend the risk factors, disease progression and prognosis for individuals affected. We describe a case of a previously healthy 17-year-old boy who tested positive for the SARS-CoV-2 virus. He presented with a 5-day history of mild influenza-like symptoms, however, quickly required ventilatory support in the intensive care unit. Two months postdischarge, he developed an isolated petechial rash on his palms and soles. His cutaneous presentation was in association with a mixed sensorimotor peripheral neuropathy, debilitating neuropathic pain and intermittent respiratory distress. We postulate that cutaneous manifestations post-COVID-19 could be indicatory of the newly identified multisystem inflammatory syndrome.

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Clinical characteristics associated with COVID-19 severity in California

Journal of Clinical and Translational Science ◽

10.1017/cts.2020.40 ◽

2020 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

Samuel J. S. Rubin ◽

Samuel R. Falkson ◽

Nicholas R. Degner ◽

Catherine Blish

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Acute Respiratory Distress Syndrome ◽

Intensive Care ◽

Clinical Characteristics ◽

Distress Syndrome ◽

Clinical Presentation ◽

Severe Disease ◽

Disease Outcomes ◽

Replicated Data

Abstract Given the rapidly progressing coronavirus disease 2019 (COVID-19) pandemic, this report on a US cohort of 54 COVID-19 patients from Stanford Hospital and data regarding risk factors for severe disease obtained at initial clinical presentation is highly important and immediately clinically relevant. We identified low presenting oxygen saturation as predictive of severe disease outcomes, such as diagnosis of pneumonia, acute respiratory distress syndrome, and admission to the intensive care unit, and also replicated data from China suggesting an association between hypertension and disease severity. Clinicians will benefit by tools to rapidly risk stratify patients at presentation by likelihood of progression to severe disease.

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