Assessment of peripheral neuropathy in post-COVID-19 patients and its relation to COVID-19 infection severity
Authors: Rashad AbdelRehem Samia Mohamed , Mohamed Galal Ahmed Mahmoud , Metwaly Mohammed Moustafa 
Published: November 2023

Abstract

Background
COVID-19 patients have encountered either central or peripheral nervous system affliction. However, there was no connection discovered between the COVID-19 very severe variant and neurological system disease, particularly neuropathy. Abnormalities in the biochemical markers of sepsis, neuroinflammation, and cytokine storm may be used to explain nervous system affection in COVID-19.

Aim of the work
This research aims to evaluate the relationship between the biochemical and radiological severity of COVID-19 and the peripheral neuropathy experienced by some COVID-19 patients.

Patient and methods
A comparative cross-sectional study was carried out on a sample of 175 adult patients who had positive COVID-19 PCR results. Patients were selected from records of those who have previously visited Ain Shams University hospitals with documented COVID-19 affection in the past two years (2020 and 2021). All patients underwent to baseline evaluations that include a complete medical history, a neurological examination, laboratory investigation, and a chest CT scan while being treated for acute COVID-19. Then nerve conduction study done for all patient have the inclusion criteria.

Result
Eighty-seven patients (50%) were female and 87 patients (50%) were male,with age range from 17 to 75 years (42.95 ± 12.12). The patient were divided to 4 groups according to COVID-19 affection, asymptomatic group 29 patient with 14 (48.3%) female and 15 (51.7%) male with age range from 20 to 63 year (43.1 ± 12.05), 49 patient mild COVID-19 with 30 (61.2%) female and 19 (38.8%) male with age 21–64 year (42.53 ± 11.31), 59 moderate COVID-19 with 26 female (44.1%) and 33 (55.9%) male with age range 23–75 year (44.51 ± 12.51), 37 severe COVID-19 with 17 female (45.9%), and 20 male (54.1%) with age 17–69 year (40.59 ± 12.71). There was no significant statistical difference between all groups regarding age (P value 0.492) and sex (P value 0.311) Regarding axonal peripheral neuropathy, there was 29 patient (100%) for asymptomatic group, 49 (100%) for the mild group, 55 (93.2%) for moderate group and 34 (91.9%) for the severe group having negative study and 0 (0%) for asymptomatic group, 0 (0%) for mild group, 4 (6.8%) for moderate group and 3 (8.1%) for severe groups having positive affection for axonal peripheral neuropathy with nonsignificant statistical difference between all groups(P value 0.110). For peripheral neuropathy there was 28 (96.6%) for asymptomatic group,44(89.8%) mild group, 50 (84.7%) moderate group and 26 (70.3%) severe group having negative study for peripheral neuropathy and 1 (3.4%) for asymptomatic group,5 (10.2%) mild group, 9 (15.3%) moderate group and 11 (29.7%) severe group having positive study for peripheral neuropathy with significant statistical difference between all groups(P value 0.017).

Conclusion
In our study, the peripheral neuropathy affection following COVID-19 infection was not statistically significant, with peripheral neuropathy being more prevalent than axonal peripheral neuropathy, borderline demyelinating LL, UL sensory motor being more frequent, and peripheral nerve affection being more prevalent in cases with a history of moderate and severe COVID-19 affection.