Peripheral Nervous System Complications of SARS-CoV-2

ABSTRACT

Objective: To further define the potential long-term peripheral nervous system complications of SARS-CoV-2 and to prognosticate the average duration of clinical symptoms. Background: Many survivors of SARS-CoV-2 present to outpatient Neurology clinics with “long-haul” symptoms including myalgia, encephalopathy, headaches, paresthesia, anosmia, movement disorders, ataxia, dysphagia, and dysarthria. Given the novelty of this virus, accurate prognosis for neurologic recovery is currently unknown. Design/Methods: Using ICD-10 and CPT coding data, we identified a cohort of patients diagnosed with COVID-19 who then presented to the Indiana University Neuroscience Center from February 1, 2020 to June 18, 2021 for further workup of weakness or neuropathy of otherwise unexplained origin. Identified patients' workup and recovery were reviewed to establish a more definitive understanding of the underlying etiology of symptoms as well as a predicted time model for recovery. Results: Fifteen patients presented to our clinic fulfilling inclusion criteria. Four had complications resulting from critical illness neuropathy/myopathy, 4 had functional neurologic disorder, 4 were diagnosed with a post-viral neuropathy, 1 was diagnosed with Guillain-Barre Syndrome, 1 was diagnosed with a post-infectious radiculitis, and 1 was lost to follow up prior to further testing. Six (40%) of these 15 patients have recovered with an average time to return to neurologic baseline of 5.2 months. Conclusions: A subset of patients who have partially recovered from SARS-CoV-2 report ongoing neurologic symptoms. Peripheral nervous system complications from SARS-CoV-2 are rare, with only 15 patients reporting such symptoms in our study. The most common etiologies identified were critical illness neuropathy, post-infectious neuropathy and functional neurologic disorder;on average, recovered patients returned to neurologic baseline in 5.2 months.