Abstract
Simple SummaryPatients with Coronavirus-2019 (COVID-19) often have reduced muscle strength and loss of sensory function. We examined several properties of the function of the nerve located at the arm and leg of 19 COVID-19 hospitalized patients before and after their rehabilitation period. We also evaluated the severity of their illness, their gait, muscle strength, and level of disability. We isolated several factors in the function of their nerves, which can be used to predict their prognosis and rehabilitation outcomes. Our findings are important since clinicians can use examinations of nerve function at early stages of the illness in order to devise an optimal treatment plan for the patient, thereby reducing the hospitalization period and promoting patient’s independence.Patients with Coronavirus-2019 (COVID-19) manifest many neuromuscular complications. We evaluated the correlations between electromyography and nerve conduction measurements among COVID-19 patients and the severity of the initial infection, as well as the rehabilitation outcomes, and searched for the factors which best predict the rehabilitation outcomes. A total of 19 COVID-19 patients (16 men; mean ± SD age 59.1 ± 10.4), with WHO clinical progression scale of 6.8 ± 2.3, received rehabilitation for 3.9 ± 2.5 months. The Functional Independence Measure (FIM), the 10 m walk test, the 6 minute walk test, and grip force were collected before and after the rehabilitation period. Motor Nerve Conduction (MNC), Sensory Nerve Conduction (SNC) and electromyographic abnormalities were measured. All of the MNC measures of the median nerve correlated with the WHO clinical progression scale and duration of acute hospitalization. The MNC and SNC measures correlated with the rehabilitation duration and with FIM at discharge. The MNC distal latency of the median and the peroneal nerves and the MNC velocity of the median and tibial nerves predicted 91.6% of the variance of the motor FIM at discharge. We conclude that nerve conduction measurements, especially in COVID-19 patients with severe illness, are important in order to predict prognosis and rehabilitation outcomes.
Highlights
Neurological manifestation appear in approximately 36% of patients with coronavirus disease 2019 (COVID-19) [1,2]
Common peroneal nerve lesions at the fibular head (68.4%) and ulnar nerve lesions at the elbow level (21.1%) were the most frequent locations. These studies provide a strong basis of evidence for electrophysiological abnormalities in COVID-19 patients that should be considered when a rehabilitation treatment plan is devised for inpatients and outpatients [14]
Five of the eight subjects who complained about neuropathic pain received neuropathic treatment
Summary
Neurological manifestation appear in approximately 36% of patients with coronavirus disease 2019 (COVID-19) [1,2]. Some peripheral injuries are attributed to prolonged immobilization in intensive care units [6,7,8] Since both central and peripheral nervous system dysfunctions may be present, etiologies supported by inflammatory or autoimmune studies are considered [6]. Previous studies that quantified the electromyography and nerve conduction among COVID-19 patients reported that most of the injuries were either Critical Illness Polyneuropathy (CIP) or Critical Illness Myopathy (CIM) or both [10,11]. Common peroneal nerve lesions at the fibular head (68.4%) and ulnar nerve lesions at the elbow level (21.1%) were the most frequent locations These studies provide a strong basis of evidence for electrophysiological abnormalities in COVID-19 patients that should be considered when a rehabilitation treatment plan is devised for inpatients and outpatients [14]
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