Peripheral Neuropathy Evaluations of Patients With Prolonged Long COVID
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology..
BACKGROUND AND OBJECTIVES: Recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection appears exponential, leaving a tail of patients reporting various long COVID symptoms including unexplained fatigue/exertional intolerance and dysautonomic and sensory concerns. Indirect evidence links long COVID to incident polyneuropathy affecting the small-fiber (sensory/autonomic) axons.
METHODS: We analyzed cross-sectional and longitudinal data from patients with World Health Organization (WHO)-defined long COVID without prior neuropathy history or risks who were referred for peripheral neuropathy evaluations. We captured standardized symptoms, examinations, objective neurodiagnostic test results, and outcomes, tracking participants for 1.4 years on average.
RESULTS: Among 17 patients (mean age 43.3 years, 69% female, 94% Caucasian, and 19% Latino), 59% had ≥1 test interpretation confirming neuropathy. These included 63% (10/16) of skin biopsies, 17% (2/12) of electrodiagnostic tests and 50% (4/8) of autonomic function tests. One patient was diagnosed with critical illness axonal neuropathy and another with multifocal demyelinating neuropathy 3 weeks after mild COVID, and ≥10 received small-fiber neuropathy diagnoses. Longitudinal improvement averaged 52%, although none reported complete resolution. For treatment, 65% (11/17) received immunotherapies (corticosteroids and/or IV immunoglobulins).
DISCUSSION: Among evaluated patients with long COVID, prolonged, often disabling, small-fiber neuropathy after mild SARS-CoV-2 was most common, beginning within 1 month of COVID-19 onset. Various evidence suggested infection-triggered immune dysregulation as a common mechanism.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
|---|---|
| Enthalten in: |
Neurology(R) neuroimmunology & neuroinflammation - 9(2022), 3 vom: 01. Mai |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Oaklander, Anne Louise [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Adrenal Cortex Hormones |
|---|
| Anmerkungen: |
Date Completed 14.03.2022 Date Revised 09.03.2023 published: Electronic-Print Citation Status MEDLINE |
|---|
| doi: |
10.1212/NXI.0000000000001146 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM337640475 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM337640475 | ||
| 003 | DE-627 | ||
| 005 | 20231225234859.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1212/NXI.0000000000001146 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1125.xml |
| 035 | |a (DE-627)NLM337640475 | ||
| 035 | |a (NLM)35232750 | ||
| 035 | |a (PII)e1146 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Oaklander, Anne Louise |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Peripheral Neuropathy Evaluations of Patients With Prolonged Long COVID |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 14.03.2022 | ||
| 500 | |a Date Revised 09.03.2023 | ||
| 500 | |a published: Electronic-Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. | ||
| 520 | |a BACKGROUND AND OBJECTIVES: Recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection appears exponential, leaving a tail of patients reporting various long COVID symptoms including unexplained fatigue/exertional intolerance and dysautonomic and sensory concerns. Indirect evidence links long COVID to incident polyneuropathy affecting the small-fiber (sensory/autonomic) axons | ||
| 520 | |a METHODS: We analyzed cross-sectional and longitudinal data from patients with World Health Organization (WHO)-defined long COVID without prior neuropathy history or risks who were referred for peripheral neuropathy evaluations. We captured standardized symptoms, examinations, objective neurodiagnostic test results, and outcomes, tracking participants for 1.4 years on average | ||
| 520 | |a RESULTS: Among 17 patients (mean age 43.3 years, 69% female, 94% Caucasian, and 19% Latino), 59% had ≥1 test interpretation confirming neuropathy. These included 63% (10/16) of skin biopsies, 17% (2/12) of electrodiagnostic tests and 50% (4/8) of autonomic function tests. One patient was diagnosed with critical illness axonal neuropathy and another with multifocal demyelinating neuropathy 3 weeks after mild COVID, and ≥10 received small-fiber neuropathy diagnoses. Longitudinal improvement averaged 52%, although none reported complete resolution. For treatment, 65% (11/17) received immunotherapies (corticosteroids and/or IV immunoglobulins) | ||
| 520 | |a DISCUSSION: Among evaluated patients with long COVID, prolonged, often disabling, small-fiber neuropathy after mild SARS-CoV-2 was most common, beginning within 1 month of COVID-19 onset. Various evidence suggested infection-triggered immune dysregulation as a common mechanism | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Intramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Adrenal Cortex Hormones |2 NLM | |
| 650 | 7 | |a Immunoglobulins, Intravenous |2 NLM | |
| 700 | 1 | |a Mills, Alexander J |e verfasserin |4 aut | |
| 700 | 1 | |a Kelley, Mary |e verfasserin |4 aut | |
| 700 | 1 | |a Toran, Lisa S |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Bryan |e verfasserin |4 aut | |
| 700 | 1 | |a Dalakas, Marinos C |e verfasserin |4 aut | |
| 700 | 1 | |a Nath, Avindra |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Neurology(R) neuroimmunology & neuroinflammation |d 2014 |g 9(2022), 3 vom: 01. Mai |w (DE-627)NLM243009216 |x 2332-7812 |7 nnns |
| 773 | 1 | 8 | |g volume:9 |g year:2022 |g number:3 |g day:01 |g month:05 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1212/NXI.0000000000001146 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 9 |j 2022 |e 3 |b 01 |c 05 | ||