Some patients with long COVID have lasting nerve damage

Almost all post-COVID neuropathy is linked to a potentially treatable immune dysfunction.


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Long Covid, also known as the Post COVID-19 condition, refers to the set of long-term symptoms that some people experience after COVID-19. Most people who develop COVID-19 fully recover. But almost 10 to 20 percent of people experience post COVID-19 symptoms after recovery.

Such symptoms of long COVID can persist at least three months after recovery. Those symptoms are faintness and rapid heart rate, shortness of breath, cognitive difficulties, chronic pain, sensory abnormalities, and muscle weakness.

According to a new study, some patients with long COVID have lasting nerve damage. This damage is probably caused by infection-triggered immune dysfunction, potentially treatable.

The study involved 17 patients with SARS-CoV-2 onset between February 21, 2020, and January 19, 2021, treated in 10 states/territories. Sixteen among them had mild COVID, whereas the one had severe COVID.

Scientists analyzed data from patients with World Health Organization (WHO)-defined long COVID without prior neuropathy history or risks referred for peripheral neuropathy evaluations. Evaluations revealed evidence of peripheral neuropathy in 59 percent. Typical symptoms of neuropathy nerve damage include weakness, sensory changes, pain in the hands and feet, and internal complaints, including fatigue.

Lead author Anne Louise Oaklander, an investigator in the Department of Neurology at MGH, said“This is one of the early papers looking into causes of long COVID, which will steadily increase in importance as acute COVID wanes. Our findings suggest that some long COVID patients had damage to their peripheral nerve fibers and that damage to the small-fiber type of nerve cell may be prominent.”

“If patients have long-COVID symptoms that aren’t otherwise explained and aren’t improving, they might benefit from discussing neuropathy with their doctor or seeing a neurologist or neuromuscular specialist.”

“Research from our team and others is clarifying what the different types of post-COVID neuropathy are and how best to diagnose and treat them. Most long COVID neuropathies described so far appear to reflect immune responses to the virus that went off course. And some patients seem to improve from standard treatments for other immune-related neuropathies.”

Journal Reference:

  1. Anne Louise Oaklander et al. Peripheral Neuropathy Evaluations of Patients With Prolonged Long COVID. DOI: 10.1212/NXI.0000000000001146


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