COVID-19 atypical Parsonage-Turner syndrome: a case report
Authors: Zazzara Maria Beatrice , Modoni Anna , Bizzarro Alessandra , Lauria Alessandra , Ciciarello Francesca , Pais Cristina , Galluzzo Vincenzo , Landi Francesco , Tostato Matteo ,   Gemelli Against COVID-19 Post-Acute Care Team , Landi Francesco , Gremese Elisa , Bernabei Roberto , Fantoni Massimo , Gasbarrini Antonio , Settanni Carlo Romano , Porcari Serena , Benvenuto Francesca , Bramato Giulia , Brandi Vincenzo , Carfì Angelo , Ciciarello Francesca , Lo Monaco Maria Rita , Martone Anna Maria , Marzetti Emanuele , Napolitano Carmen , Galluzzo Vincenzo , Pagano Francesco , Pais Cristina , Rocchi Sara , Rota Elisabetta , Salerno Andrea , Tosato Matteo , Tritto Marcello , Calvani Riccardo , Zazzara Maria Beatrice , Catalano Lucio , Picca Anna , Savera Giulia , Cauda Roberto , Murri Rita , Cingolani Antonella , Ventura Giulio , Taddei Eleonora , Moschese Davide , Ciccullo Arturo , Fantoni Massimo , Stella Leonardo , Addolorato Giovanni , Franceschi Francesco , Mingrone Gertrude , Zocco Maria Assunta , Sanguinetti Maurizio , Cattani Paola , Marchetti Simona , Posteraro Brunella , Sali Michela , Bizzarro Alessandra , Lauria Alessandra , Rizzo Stanislao , Savastano Maria Cristina , Gambini Gloria , Cozzupoli Maria Grazia , Culiersi Carola , Passali Giulio Cesare , Paludetti Gaetano , Galli Jacopo , Crudo Fabrizio , Di Cintio Giovanni , Longobardi Ylenia , Tricarico Laura , Santantonio Mariaconsiglia , Di Cesare Tiziana , Guarino Mariateresa , Corbò Marco , Settimi Stefano , Mele Dario , Brigato Francesca , Buonsenso Danilo , Valentini Piero , Sinatti Dario , De Rose Gabriella , Richeldi Luca , Lombardi Francesco , Calabrese Angelo , Varone Francesco , Leone Paolo Maria , Siciliano Matteo , Corbo Giuseppe Maria , Montemurro Giuliano , Calvello Mariarosaria , Intini Enrica , Simonetti Jacopo , Pasciuto Giuliana , Adiletta Veronica , Sofia Carmelo , Licata Maria Angela , Sani Gabriele , Janiri Delfina , Simonetti Alessio , Modica Marco , Montanari Silvia , Catinari Antonello , Terenzi Beatrice , Natale Luigi , Larici Anna Rita , Marano Riccardo , Pirronti Tommaso , Infante Amato , Paglionico Annamaria , Petricca Luca , Tolusso Barbara , Alivernini Stefano , Di Mario Clara , Santoliquido Angelo , Santoro Luca , Nesci Antonio , Di Giorgio Angela 
Published: March 2022

Abstract
Background
Neurological manifestations of Sars-CoV-2 infection have been described since March 2020 and include both central and peripheral nervous system manifestations. Neurological symptoms, such as headache or persistent loss of smell and taste, have also been documented in COVID-19 long-haulers. Moreover, long lasting fatigue, mild cognitive impairment and sleep disorders appear to be frequent long term neurological manifestations after hospitalization due to COVID-19. Less is known in relation to peripheral nerve injury related to Sars-CoV-2 infection.

Case presentation
We report the case of a 47-year-old female presenting with a unilateral chest pain radiating to the left arm lasting for more than two months after recovery from Sars-CoV-2 infection. After referral to our post-acute outpatient service for COVID-19 long haulers, she was diagnosed with a unilateral, atypical, pure sensory brachial plexus neuritis potentially related to COVID-19, which occurred during the acute phase of a mild Sars-CoV-2 infection and persisted for months after resolution of the infection.

Conclusions
We presented a case of atypical Parsonage-Turner syndrome potentially triggered by Sars-CoV-2 infection, with symptoms and repercussion lasting after viral clearance. A direct involvement of the virus remains uncertain, and the physiopathology is unclear. The treatment of COVID-19 and its long-term consequences represents a relatively new challenge for clinicians and health care providers. A multidisciplinary approach to following-up COVID-19 survivors is strongly advised.