Josef Finsterer1, Fulvio Alexandre Scorza2, Carla Alessandra Scorza2, Ana Claudia Fiorini3,4. 1. Klinik Landstrasse, Messerli Institute, Vienna, Austria. 2. Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Neurociência, São Paulo SP, Brazil. 3. Pontifícia Universidade Católica de São Paulo, Programa de Pós-Graduação em Fonoaudiologia, São Paulo SP, Brazil. 4. Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Fonoaudiologia, São Paulo SP, Brazil.
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.
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.
Authors: Fernanda Chiarion Sassi; Ana Paula Ritto; Maíra Santilli de Lima; Cirley Novais Valente Junior; Paulo Francisco Guerreiro Cardoso; Bruno Zilberstein; Paulo Hilário Nascimento Saldiva; Claudia Regina Furquim de Andrade Journal: PLoS One Date: 2022-06-16 Impact factor: 3.752
Authors: Jéssica Araujo da Paixão de Oliveira; Mariana Martins de Athaide; Atta Ur Rahman; Mayara Garcia de Mattos Barbosa; Marcia Maria Jardim; Milton Ozório Moraes; Roberta Olmo Pinheiro Journal: Front Cell Infect Microbiol Date: 2022-02-24 Impact factor: 5.293
Authors: Maria Luiza G A Seixas; Lucas Pari Mitre; Shahin Shams; Gabriel Barbugian Lanzuolo; Cynthia Silva Bartolomeo; Eduardo A Silva; Carla Maximo Prado; Rodrigo Ureshino; Roberta Sessa Stilhano Journal: Front Nutr Date: 2022-02-10