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Neuromuscular presentations in patients with COVID-19.
Paliwal, Vimal Kumar; Garg, Ravindra Kumar; Gupta, Ankit; Tejan, Nidhi.
  • Paliwal VK; Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, 226014, India. dr_vimalkpaliwal@rediffmail.com.
  • Garg RK; Department of Neurology, King George Medical University, Lucknow, UP, India.
  • Gupta A; Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, 226014, India.
  • Tejan N; Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, 226014, India.
Neurol Sci ; 41(11): 3039-3056, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-758038
ABSTRACT
COVID-19 is caused by the coronavirus SARS-CoV-2 that has an affinity for neural tissue. There are reports of encephalitis, encephalopathy, cranial neuropathy, Guillain-Barrè syndrome, and myositis/rhabdomyolysis in patients with COVID-19. In this review, we focused on the neuromuscular manifestations of SARS-CoV-2 infection. We analyzed all published reports on SARS-CoV-2-related peripheral nerve, neuromuscular junction, muscle, and cranial nerve disorders. Olfactory and gustatory dysfunction is now accepted as an early manifestation of COVID-19 infection. Inflammation, edema, and axonal damage of olfactory bulb have been shown in autopsy of patients who died of COVID-19. Olfactory pathway is suggested as a portal of entry of SARS-CoV-2 in the brain. Similar to involvement of olfactory bulb, isolated oculomotor, trochlear and facial nerve has been described. Increasing reports Guillain-Barrè syndrome secondary to COVID-19 are being published. Unlike typical GBS, most of COVID-19-related GBS were elderly, had concomitant pneumonia or ARDS, more prevalent demyelinating neuropathy, and relatively poor outcome. Myalgia is described among the common symptoms of COVID-19 after fever, cough, and sore throat. Duration of myalgia may be related to the severity of COVID-19 disease. Few patients had muscle weakness and elevated creatine kinase along with elevated levels of acute-phase reactants. All these patients with myositis/rhabdomyolysis had severe respiratory complications related to COVID-19. A handful of patients with myasthenia gravis showed exacerbation of their disease after acquiring COVID-19 disease. Most of these patients recovered with either intravenous immunoglobulins or steroids.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Neuromuscular Diseases Type of study: Prognostic study Topics: Long Covid Limits: Adolescent / Aged / Female / Humans / Male / Middle aged Language: English Journal: Neurol Sci Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: S10072-020-04708-8

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Neuromuscular Diseases Type of study: Prognostic study Topics: Long Covid Limits: Adolescent / Aged / Female / Humans / Male / Middle aged Language: English Journal: Neurol Sci Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: S10072-020-04708-8