SARS-CoV-2 infection in the development of peripheral neuropathies

Introduction: Although respiratory symptoms are the characteristic findings of COVID- 19, this disease may also present with neurological manifestations, since SARS-CoV- 2 showed several degrees of neurotropism. Objectives: To review the influence of SARS-CoV-2 infection on the development of peripheral neuropathies. Methods: Integrative review carried out at PUBMED with the descriptors peripheral neuropathy, SARS-CoV-2 and COVID-19, and having as inclusion criteria full texts and in English in the period from 11/2019 to 05/2021. The selection has made among those compatible with the objectives of the work. Results: Peripheral neuropathy was observed in less than 1% of patients with COVID-19. The virus can cause acute polyradiculoneuropathy regardless of pulmonary disease, and may occur due to dysregulation of the immune system caused by SARS-CoV-2. Systemic hyper-inflammation with macrophage activation syndrome has been proposed for patients with COVID-19. Such immunomediated manifestations typically occur after the decrease in the acute phase of disease. The most commonly reported symptoms in peripheral nervous system involvement are ageusia, anosmia, diplopia, facial nerve paralysis, polyneuritis, myasthenic crisis, musculoskeletal injuries, and neuralgia. Conclusion: As soon as possible recognition of peripheral neuropathy may result in better clinical goals for patients and understanding these manifestations will contribute to the development of improved treatment. Although only a small percentage of patients with COVID-19 develop peripheral neuropathy, in a pandemic this can have a major impact.