Session Title: Research Spotlight: Pandemic
Session Time: None. Available on demand.
Disclosures: Tunc C. Kiymaz, MD: No financial relationships or conflicts of interest
Objective: The presence of critical illness neuropathy (CIN) and critical illness myopathy (CIM) is well studied following intensive care unit (ICU) hospitalizations. However, there is very limited data concerning the association between COVID-19, CIM, CIN, and other neuropathies. This study retrospectively analyzed the electrodiagnostic (EDX) findings of all patients with a COVID-19 history referred to our laboratory.
Design: Case series, Retrospective chart reviewSetting : Electrodiagnostic center at a tertiary care rehabilitation hospitalParticipants : All patients who underwent EDX studies as an inpatient or outpatient at this electrodiagnostic laboratory following a COVID-19 diagnosis from May 2020 through February 2021 (n=16)
Interventions: Not applicable
Main Outcome Measures: EDX evidence of CIN, CIM, and/or additional peripheral nerve involvement
Results: There were 16 patients who had a history of COVID-19 infection and were referred for EDX studies for a variety of different patterns of weakness, numbness, and paresthesia. Of this group, 10 patients had hospitalizations in the ICU requiring intubation and prone positioning. Of these 10 patients, all 10 were diagnosed with CIN, 8 with CIM, and 8 with both diagnoses. Additionally, all 10 post-ICU patients had evidence of other peripheral involvement, such as brachial plexopathies and isolated mononeuropathies.Conclusions: The presence of CIN and CIM in these patients were expected given prolonged ICU stay associated with a COVID-19 infection. However, the complete presence of CIN and near-complete presence of CIM in this series raises suspicion that a COVID-19 infection, in addition to the associated ICU stay, may cause a higher incidence of these diagnoses, possibly through direct viral infection via the angiotensin-converting enzyme 2 (ACE-2) receptors. Prospective studies will help to answer etiological questions. If the incidence truly is high enough, then widespread and early EDX studies are indicated for COVID-19 ICU patients for prognostication and appropriate planning of a post-ICU rehabilitation regimen.
Level of Evidence: Level IV
To cite this abstract in AMA style:Kiymaz TC, Zuziak A, Sridhara CR. A Case Series: Critical Illness Neuropathy and Myopathy in post-covid-19 Patients [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/a-case-series-critical-illness-neuropathy-and-myopathy-in-post-covid-19-patients/. Accessed December 3, 2023.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/a-case-series-critical-illness-neuropathy-and-myopathy-in-post-covid-19-patients/