Bladder and bowel incontinence in COVID-19.

PEER REVIEW

The peer review history for this article is available at https://publons.com/publon/10.1002/jmv.26849.

To the Editor,

Coronavirus 2019 (COVID‐19) or severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is an acute respiratory disease that has infected more than 99 million people and killed more than two million people as of January 26, 2021. COVID‐19 has various manifestations such as respiratory, cardiovascular, gastrointestinal, renal, neurological, and so forth.

With the increase in research about COVID‐19, various neurological complications have been reported in these patients. Some of the neurological complications that have been reported in COVID‐19 patients include headache, anosmia, hyposmia, dysgeusia, impaired consciousness, seizures, encephalitis, demyelinating neuropathy. ,

SARS‐CoV‐2 can directly or indirectly damage neurons by invading the central nervous system and peripheral nervous system. The pro‐inflammatory “cytokine storm” caused by SARS‐CoV‐2 infection can cause neuroinflammation, which eventually leads to neuron  demyelination. It has already been proven that some viral infections cause various demyelinating diseases in animals and humans. Demyelinating neuropathy is one of the COVID‐19 neurological complications. Neuron demyelination can cause several disorders. Some of them include diplopia, ataxia, clonus, dysarthria, paraesthesia in hands and feet, hemiparesis, incoordination, weakness, unsteadiness, and hearing loss. , Demyelinating disorders have a wide range and are not limited to the cases mentioned. For example, acute demyelinating inflammatory polyneuropathy, the most common type of Guillain‐Barré syndrome, has been reported as a complication in patients with COVID‐19.

To the best of our knowledge, inflammation, and demyelination in the pudendal nerve can lead to bladder and bowel incontinence. , Pudendal neuropathy was reported in some viral infections such as HIV and herpes zoster, and multiple sclerosis. Due to innervation of anal and urethral sphincter by the pudendal nerve, It seems COVID‐19 by inflammation and demyelination in the pudendal nerve, causes bladder and bowel incontinence.

Therefore, these COVID‐19 probable neurological complications should be considered important because they can have diagnostic value. Hence, medical staff should consider the possibility of COVID‐19 in a suspected patient if they observe these symptoms, and also, people should be aware of COVID‐19 when faced with these symptoms. Awareness of the broader symptoms of the disease can lead to a faster therapeutic procedure and consequently reduce the mortality rate.

CONFLICT OF INTERESTS

The authors declare that there are no conflict of interests.