Prevalence of peripheral neuropathy and myopathy in patients post‐COVID‐19 infection, Saif et al.

[boolybooly]

Prevalence of peripheral neuropathy and myopathy in patients post‐COVID‐19 infection - PMC

Severe acute respiratory syndrome (SARS‐CoV‐2), caused by the Coronavirus 2019 (COVID‐19), has become a life‐threatening epidemic, affecting multiple organs, including the nervous system. Recent studies have documented that COVID‐19‐associated ...

pmc.ncbi.nlm.nih.gov

Results​

The prevalence of peripheral neuropathy and myopathy in post‐COVID‐19 patients was 56.3% among all patients. A significant difference was detected among patients of both groups regarding serum creatine phosphokinase level, clinical signs, and electrophysiologic findings of neuropathy and myopathy compared to the control group

This is discussed in the following article and by comparison the usual rate for peripheral neuropathy in older age groups is 8%. There is obviously something going on here.

When Nerve Pain and Numbness Are Linked to Long COVID

Clinicians have recently identified peripheral neuropathy in some Long COVID patients.

www.yalemedicine.org

 

[boolybooly]

Discussion elsewhere about covid related diabetes onset touched on the possibility that covid's attack on ACE2 receptors could play a part in related pathology.

Post in thread '[COVID-19] Pandemic is Associated with a Substantial Rise in Frequency and Severity of Presentation of Youth-Onset Type 2 Diabetes, 2022, Magge et al'

Saturday at 12:00 AM

These papers support the concept that covid reduces ACE2 thus increases angiotensin II in patients which can lead to insulin resistance.

Angiotensin converting enzyme 2 level and its significance in COVID‐19 and other diseases patients

Angiotensin converting enzyme 2 level and its significance in COVID‐19 and other diseases patients - PMC

Angiotensin‐converting enzyme 2 (ACE2) expressions and its modulation are of great interest as being a key receptor for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV2) and the protective arm of the rennin‐angiotensin axis, maintaining ...

pmc.ncbi.nlm.nih.gov

Severe acute respiratory syndrome coronavirus 2 attenuates the ACE2 levels, essential for the conversion of Ang II to Ang (1–7). Thus, Ang II accumulates and binds to the angiotensin type 1 receptor (AT1R) on the immune cell membrane; this process activates the NF‐κB pathway. It, in turn...

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Hypothetically speaking, i.e. just me thinking out loud, this could relate to peripheral neuropathy via two mechanisms.

One is vasoconstriction due to non cleavage of angiotensin II and imbalance of the RAS (renin-angiotensin system) resulting in obstructed vasodilation response, leading to poor blood supply to peripheral nerves.

Two is insulin resistance due to angiotensin II non cleavage leading to excess angII dysregulating insulin reception mechanisms e.g. by inhibiting the translocation of GLUT4 and inhibiting phosphorylation of insulin receptor substrate-1 (IRS-1) etc leading to a restricted glucose supply to peripheral nerves.

 

[Eleanor]

Prevalence of post‐COVID‐19 neuromuscular affection among all patients was 56.3%, and it was 81% among symptomatic patients and 28.8% among the asymptomatic group.

In the symptomatic group, about 57.2% had neuropathy, and 24% had myopathy vs 21%, and 7.8%, respectively, in the asymptomatic group.

42.8% of symptomatic patients were hospitalized vs 6.3% in the asymptomatic group

Bureau et al32 observed the low incidence of peripheral neuropathy post‐COVID‐19 infection in their study group. That could be explained by the fact their study group patients had a mild COVID‐19 infection as they fully recovered after a short period and they were not hospitalized.


In agreement with our results, Frithiof et al33 documented that prolonged hospitalization and severe respiratory distress symptoms are independent predictors closely related to neuromuscular complications after infection with COVID‐19.