Overcoming Neuromuscular Sequelae After Severe SARS-CoV-2 Infection: A Case Report
DOI :
https://doi.org/10.25759/spmfr.470Mots-clés :
COVID-19/complications, Muscle Weakness/ rehabilitation, Neurologic Manifestations/rehabilitation, Post- Acute COVID-19 Syndrome, SARS-CoV-2Résumé
Neurologic symptoms can occur in up to 65% of COVID-19 cases. This article aims to raise awareness to such neurologic impairments. We describe the case of a 52-year-old patient who required intubation and mechanical ventilation due to severe SARS-CoV-2 infection with acute respiratory distress syndrome. After extubation, he presented tetraparesis, with plegic right upper limb, global weakness of the left upper limb, and lower limb proximal weakness without distal muscle activation. Deep tendon reflexes were either decreased or absent. Right upper limb tactile and algic hypoesthesia and distal hyperesthesia in both lower limbs were also noticed. Following extensive investigation, intensive care unit-acquired weakness and right brachial plexus injury were diagnosed. He was engaged in a rehabilitation program and showed slow yet progressive improvement. At one-year follow-up evaluation, he was capable of performing independent gait with bilateral foot-up orthosis and used a tripod for unstable floorings, but maintained a non-functional right upper limb. This article describes multiple neurologic sequelae seen in a patient with severe SARS-CoV-2 infection after Intensive Care Unit hospitalization. Neurologic involvement associated to SARS-CoV-2 infection and its respective therapeutic management must be taken into account early on by medical teams and rehabilitation care should be offered.Téléchargements
Références
Li X, Zai J, Zhao Q, Nie Q, Li Y, Foley BT, et al. Evolutionary history, potential intermediate animal host, and cross-species analyses of SARS-CoV-2. J Med Virol. 2020;92:602-11. doi: 10.1002/jmv.25731.
Kase Y, Okano H. Neurological pathogenesis of SARS-CoV-2 (COVID-19): from virological features to clinical symptoms. Inflamm Regen. 2021;41:15. doi: 10.1186/s41232-021-00165-8.
Solomon T. Neurological infection with SARS-CoV-2 – the story so far. Nat Rev Neurol. 2021;17:65-6. doi: 10.1038/s41582-020-00453-w.
Carlos CR, Gerardo MM, Jaime OG, Isauro GHL, Dios APJ, Neurosurgical Group. Prevalence of neurological manifestations in COVID-19 and their association with mortality. Neurology Perspectives. 2021;1:11-6. doi: 10.1016/j.neurop.2021.03.002.
Romero-Sánchez CM, Díaz-Maroto I, Fernández-Díaz E, Sánchez-Larsen A, Layos-Romero A, García-García J, et al. Neurologic manifestations in hospitalized patients with COVID-19: The ALBACOVID registry. Neurology. 2020;95:e1060-70. doi: 10.1212/WNL.0000000000009937.
Sharifian-dorche M, Huot P, Osherov M, Wen D, Saveriano A, Giacomini PS, et al. Neurological complications of coronavirus infection; a comparative review and lessons learned during the COVID-19 pandemic. J Neurol Sci. 2020;417:117085. doi: 10.1016/j.jns.2020.117085.
Malik GR, Wolfe AR, Soriano R, Rydberg L, Wolfe LF, Deshmukh S, et al. Injury-prone: peripheral nerve injuries associated with prone positioning for COVID-19-related acute respiratory distress syndrome. Br J Anaesth. 2020;125: e478-80. doi: 10.1016/j.bja.2020.08.045.
Makhoul E, Aklinski JL, Miller J, Leonard C, Backer S, Kahar P, et al. A review of COVID-19 in relation to metabolic syndrome: obesity, hypertension, diabetes, and dyslipidemia. Cureus. 2022;14: e27438. doi:10.7759/ cureus.27438.
Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chem Neurosci. 2020;11:995-8. doi: 10.1021/acschemneuro.0c00122.
Desforges M, Le Coupanec A, Dubeau P, Bourgouin A, Lajoie L, Dubé M, et al. Human coronaviruses and other respiratory viruses: underestimated opportunistic pathogens of the central nervous system? Viruses. 2020;12:14. doi: 10.3390/v12010014.
Hokkoku K, Erra C, Cuccagna C, Coraci D, Gatto DM, Glorioso D, et al. Intensive care unit-acquired weakness and positioning-related peripheral nerve injuries in COVID-19: a case series of three patients and the latest literature review. Brain Sci. 2021;11:1177. doi: 10.3390/brainsci11091177.
Nasuelli NA, Pettinaroli R, Godi L, Savoini C, De Marchi F, Mazzini L, et al. Critical illness neuro-myopathy (CINM) and focal amyotrophy in intensive care unit (ICU) patients with SARS-CoV-2: a case series. Neurol Sci. 2021;42:1119-21. doi: 10.1007/s10072-020-04820-9.
Cabañes-martínez L, Villadóniga M, González-rodríguez L, Araque L, Díaz-Cid A, Ruz-Caracuel I, et al. Neuromuscular involvement in COVID-19 critically ill patients. Clin Neurophysiol. 2020;131:2809-16. doi: 10.1016/j.clinph.2020.09.017.
Bagnato S, Boccagni C, Marino G, Prestandrea C, D’Agostino T, Rubino F. Critical illness myopathy after COVID-19. Int J Infect Dis. 2020;99:276-8. doi: 10.1016/j.ijid.2020.07.072.
Hermans G, Van den Berghe G. Clinical review: intensive care unit acquired weakness. Crit Care. 2015;19:274. doi: 10.1186/s13054-015-0993-7.
Sidiras G, Patsaki I, Karatzanos E, Dakoutrou M, Kouvarakos A, Mitsiou G, et al. Long term follow-up of quality of life and functional ability in patients with ICU acquired weakness – A post hoc analysis. J Crit Care. 2019;53:223-30. doi: 10.1016/j.jcrc.2019.06.022.
Van Aerde N, Van den Berghe G, Wilmer A, Gosselink R, Hermans G, COVID-19 Consortium. Intensive care unit acquired muscle weakness in COVID-19 patients. Intensive Care Med. 2020;46:2083-5. doi: 10.1007/s00134-020-06244-7.
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