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Intensive Care Unit-Acquired Weakness and Positioning-Related Peripheral Nerve Injuries in COVID-19: A Case Series of Three Patients and the Latest Literature Review.
Hokkoku, Keiichi; Erra, Carmen; Cuccagna, Cristina; Coraci, Daniele; Gatto, Dario Mattia; Glorioso, Davide; Padua, Luca.
  • Hokkoku K; UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
  • Erra C; Department of Neurology, Teikyo University School of Medicine, Tokyo 173-8605, Japan.
  • Cuccagna C; UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
  • Coraci D; Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
  • Gatto DM; UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
  • Glorioso D; Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
  • Padua L; UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Brain Sci ; 11(9)2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1390538
ABSTRACT
A subgroup of COVID-19 patients requires intensive respiratory care. The prolonged immobilization and aggressive treatments predispose these patients to develop intensive care unit-acquired weakness (ICUAW). Furthermore, this condition could increase the chance of positioning-related peripheral nerve injuries. On the basis of the latest literature review, we describe a case series of three patients with COVID-19 who developed ICUAW complicated by positioning-related peripheral nerve injuries Every patient presented sensorimotor axonal polyneuropathy and concomitant myopathy in electrophysiological studies. Furthermore, muscle MRI helped the diagnosis of ICUAW, showing massive damage predominantly in the proximal muscles. Notably, nerve ultrasound detected positioning-related peripheral nerve injuries, even though the concomitant ICUAW substantially masked their clinical features. During the acute phase of severe COVID-19 infection, most medical attention tends to be assigned to critical care management, and neuromuscular complications such as ICUAW and positioning-related peripheral nerve injuries could be underestimated. Hence, when starting post-ICU care for COVID-19 cases, the combination of electrophysiological and imaging studies will aid appropriate evaluation on the patients with COVID-19-related ICUAW.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study / Reviews Language: English Year: 2021 Document Type: Article Affiliation country: Brainsci11091177

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study / Reviews Language: English Year: 2021 Document Type: Article Affiliation country: Brainsci11091177