COVID-19 and Neuromuscular Involvement: A Case Series and Brief Review of Literature

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Moradi Katayoun; Forogh Bijan; Sadeghi Shahram; Khabbaz Mohammad Sadegh; Attari Arezoo; Taghizadeh Fatemeh Sadat; Yousefi Naseh

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Journal Paper

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Journal: Journal of Iranian Medical Council Year:621 | Volume: | Issue: Page(s): 377-388

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Title

COVID-19 and Neuromuscular Involvement: A Case Series and Brief Review of Literature

Author(s)

Keywords

COVID-19Q4

Critical illnessQ4

Muscular diseasesQ4

PolyneuropathiesQ4

PolyradiculoneuropathyQ4

Abstract

Background: Tough COVID-19 predominantly affects the respiratory tract, and extra-pulmonary manifestations, including neuromuscular complaints have been associated with this disorder. It is vital to monitor COVID-19 cases for the occurrence of Neuromuscular Disorders (NMDs), which could be overshadowed by severe respiratory and cardiovascular symptoms. In this study, we reported electrophysiological findings of a series of COVID-19 patients with complaints of paresthesia and weakness.Methods: In this case series, the Electrodiagnostic studies (EDX) of 36 patients with recent complaints of weakness or paresthesia and a history of COVID-19 before symptoms were reported.Results: 12 cases (33.3%) had abnormal EDX, five males and seven females, with a mean age of 51.42±11.49 years, history of hospitalization in five cases (41.7%), and ICU admission in four (33.3%). Seven cases were concluded as having a predominantly axonal type polyneuropathy (five sensory-motor and two sensory Polyneuropathies). Of these seven, one was suggestive of Critical illness Neuropathy (CIN). Three cases demonstrated a myopathic pattern with a history of ICU admission, hence the impression of Critical illness Myopathy (CIM). In addition, one of these three, developed both myopathy and neuropathy and thus, is considered as having CIM/N. One case was diagnosed with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). The last case demonstrated an inflammatory involvement of lumbosacral roots (COVID-19-related radiculitis).Conclusion: COVID-19 could be associated with a wide range of NMDs. In this study, the presence of axonal polyneuropathy, CIDP, and myopathy was demonstrated following SAR-COV-2 infection. Also, CIN/M was observed in COVID-19 patients with a history of ICU admission.

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