Abstract
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. Literature review. 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. 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.
Highlights
Infection with SARS-CoV-2 (COVID-19) causes pneumonia, and neurological, cardiac, renal, hepatic, pancreatic, and gastrointestinal compromise[1,2]
The most common causes of SARS‐CoV‐2‐associated peripheral neuropathy include Guillain-Barré syndrome (GBS), drugs used to treat symptoms of COVID-19, pre-existing diabetes, and compression neuropathies due to prone bedding in the Intensive Care Unit (ICU)
Whether diabetes or prolonged ICU stay caused neuropathy in the 13 patients with pre-existing diabetes was not differentiated in the appropriate papers
Summary
Infection with SARS-CoV-2 (COVID-19) causes pneumonia, and neurological, cardiac, renal, hepatic, pancreatic, and gastrointestinal compromise[1,2]. Neurological involvement following the infection has been increasingly acknowledged and includes impairment of the central nervous system (CNS), and of the peripheral nervous system (PNS)[3], SARS-CoV-2-associated PNS disease includes rhabdomyolysis, myopathy, myositis, myasthenia, myasthenic syndrome, polyradiculitis with or without involvement of cranial nerves, and peripheral neuropathy. 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 neuropathy
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