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BMJ Case Rep ; 14(3)2021 Mar 25.
Article in English | MEDLINE | ID: covidwho-1153656


COVID-19 affects a wide spectrum of organ systems. We report a 52-year-old man with hypertension and newly diagnosed diabetes mellitus who presented with hypoxic respiratory failure due to COVID-19 and developed severe brachial plexopathy. He was not treated with prone positioning respiratory therapy. Associated with the flaccid, painfully numb left upper extremity was a livedoid, purpuric rash on his left hand and forearm consistent with COVID-19-induced microangiopathy. Neuroimaging and electrophysiological data were consistent with near diffuse left brachial plexitis with selective sparing of axillary, suprascapular and pectoral fascicles. Given his microangiopathic rash, elevated D-dimers and paucifascicular plexopathy, we postulate a patchy microvascular thrombotic plexopathy. Providers should be aware of this significant and potentially under-recognised neurologic complication of COVID-19.

Brachial Plexus Neuropathies/etiology , COVID-19/complications , Arm/pathology , Brachial Plexus Neuropathies/diagnosis , COVID-19/diagnosis , Diabetes Mellitus , Exanthema/complications , Fibrin Fibrinogen Degradation Products/analysis , Humans , Hypertension/complications , Magnetic Resonance Imaging , Male , Middle Aged , Neuralgia/complications , Patient Positioning/adverse effects , Respiratory Insufficiency/etiology , SARS-CoV-2/isolation & purification
Neurologia (Engl Ed) ; 35(9): 628-632, 2020.
Article in English, Spanish | MEDLINE | ID: covidwho-747866


INTRODUCTION: In recent months, doubts have arisen among patients, general practitioners, and neurologists as to whether some drugs commonly used in patients with headaches and neuralgia may favour or complicate the disease caused by SARS-CoV-2. MATERIAL AND METHODS: We collected information on the opinions of scientific societies and medicines agencies (American, European, and Spanish) to clarify doubts regarding the use of drugs such as lisinopril, candesartan, ibuprofen, corticosteroids, carbamazepine, and monoclonal antibodies targeting the calcitonin gene-related peptide in the context of the COVID-19 pandemic. RESULTS: We make recommendations about the use of standard headache treatments in the context of the COVID-19 pandemic, based on the current scientific evidence. CONCLUSIONS: At present, there is no robust scientific argument to formally contraindicate any of the standard treatments employed for headaches and neuralgias.

Analgesics/adverse effects , Coronavirus Infections/complications , Headache/drug therapy , Neuralgia/drug therapy , Pneumonia, Viral/complications , Adrenal Cortex Hormones/adverse effects , Adrenal Cortex Hormones/therapeutic use , Analgesics/pharmacology , Analgesics/therapeutic use , Angiotensin-Converting Enzyme 2 , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal/therapeutic use , Anticonvulsants/adverse effects , Anticonvulsants/therapeutic use , Antihypertensive Agents/adverse effects , Antihypertensive Agents/therapeutic use , Antiviral Agents/pharmacology , Benzimidazoles/adverse effects , Benzimidazoles/therapeutic use , Betacoronavirus , Biphenyl Compounds , COVID-19 , Calcitonin Gene-Related Peptide Receptor Antagonists/adverse effects , Calcitonin Gene-Related Peptide Receptor Antagonists/therapeutic use , Carbamazepine/adverse effects , Carbamazepine/therapeutic use , Coronavirus Infections/drug therapy , Disease Susceptibility/chemically induced , Drug Interactions , Enzyme Induction/drug effects , Headache/complications , Headache/prevention & control , Humans , Ibuprofen/adverse effects , Ibuprofen/pharmacology , Ibuprofen/therapeutic use , Lisinopril/adverse effects , Lisinopril/therapeutic use , Neuralgia/complications , Pandemics , Peptidyl-Dipeptidase A/biosynthesis , Peptidyl-Dipeptidase A/genetics , Receptors, Virus/biosynthesis , Receptors, Virus/genetics , Risk Factors , SARS-CoV-2 , Tetrazoles/adverse effects , Tetrazoles/therapeutic use