Washington University Study Reveals That SARS-Cov-2 Infections Increases Occurrences Of Peripheral Neuropathy Symptoms And Pain

COVID-19-Peripheral Neuropathy: A new study by researchers from the Washington University School of Medicine, St. Louis-USA has found that SARS-Cov-2 infections increases occurrences of peripheral neuropathy symptoms and pain.


Peripheral neuropathy develops when nerves in the body's extremities, such as the hands, feet and arms, are damaged. The symptoms depend on which nerves are affected. Neuropathy symptoms ultimately depend on the underlying cause and the individual, but they can include:
 
-Temporary or permanent numbness
-Tingling, prickling, or burning sensation
-Increased sensitivity to touch
-Pain
-Muscle weakness or wasting
-Paralysis
-Dysfunction in organs or glands
-Impairment to urination and sexual function
 
It has already been known that SARS-CoV-2 infections can cause neurological sequelae after the resolution of symptomatic COVID-19 illness, but the occurrence of peripheral neuropathy symptoms and cranial nerve dysfunction is to date unknown.
 
The study aimed to characterize the occurrence and severity of pain and peripheral neuropathy symptoms in patients with SARS-CoV-2 infection.
 
The COVID-19-Peripheral Neuropathy research was an observational cohort study that included adults tested for a SARS-CoV-2 infection at an academic medical center (assigned as CV+ or control, based on test results). 30-90 days after the index SARS-CoV-2 test, patients completed a web-based questionnaire assessing pain, peripheral neuropathy-related sensory symptoms, and symptoms in the distribution of cranial nerves (current symptoms, symptoms at testing and two weeks thereafter). Univariate analyses compared the outcomes between the groups. Multivariable analysis was used to determine the odds for neuropathy symptoms after adjusting for key baseline variables.
 
A total of 1556 participants were included: 542 CV+ and 1014 controls.
 
The study findings showed that CV+ patients reported a higher occurrence of peripheral neuropathy symptoms in the extremities anytime within 90 days post-infection (28.8% vs 12.9%, OR [95%CI] =2.72 [2.10-3.54]), as well as such symptoms persisting up to 90 days after infection (6.1% vs 1.9%, OR=3.39 [1.91-6.03]).
 
Also, the occurrence of pain in the extremities was higher in the CV+ group (24.2% vs 9.8%, OR=2.95 [2.21-3.91]). SARS-CoV-2 infection was also associated with higher occurrence of peripheral neuropathy symptoms, after adjusting for the history of chronic pain and neuropathy (OR=3.19 [2.37-4.29].
 
The study findings suggest that SARS-CoV-2 infection was independently associated with an increased risk of pain and peripheral neuropathy symptoms.
The study findings were published in the peer reviewed journal: Pain. https://journals.lww.com/pain/Abstract/9900/Post_acute_sensory_neurological_sequelae_in.32.aspx
 
This study findings adds to a growing body of evidence that, for many, problems related to COVID-19 linger longer than the initial infection.
 
Th study team found that some individuals infected during the pande mic's early months experienced peripheral neuropathy ie pain, tingling and numbness in the hands and feet during and following their bouts with the virus.
 
The study which involved more than 1,500 individuals who were tested for SARS-CoV-2 during the first year of the pandemic, found that those who tested positive for the virus were about three times more likely to report pain, numbness or tingling in their hands and feet as those with negative tests.
 
Senior researcher Dr Simon Haroutounian, Ph.D., chief of clinical research at the Washington University Pain Center told Thailand Medical News, "Several viral infections such as HIV and shingles are associated with peripheral neuropathy because viruses can damage nerves. We found that nearly 30% of patients who tested positive for COVID-19 also reported neuropathy problems at the time of their diagnosis, and that for 6% to 7% of them, the symptoms persisted for at least two weeks, and up to three months, suggesting this virus may have lingering effects on peripheral nerves."
 
Dr Haroutounian, who also is an associate professor of anesthesiology and director of the department's Division of Clinical and Translational Research, said some patients who traced the start of their neuropathy symptoms to a COVID-19 infection have sought treatment at the Washington University Pain Center.
 
However, most of those in the study reported problems that were rated as mild to moderate and may not have sought help from a pain specialist.
 
Dr Haroutounian added, "It is important to understand whether a viral infection is associated with an increased risk of neuropathy. In the case of HIV, we didn't realize it was causing neuropathy for several years after the AIDS epidemic began. Consequently, many people went undiagnosed with neuropathy and untreated for the pain associated with the problem."
 
Dr Haroutounian warned that the same may be true now for patients with neuropathy following COVID-19. There is no established diagnosis of neuropathy related to COVID-19, but Haroutounian explained that, regardless of the cause, current treatments for neuropathy are somewhat similar. Pain specialists use the same types of medications to treat peripheral neuropathy, whether it's caused by diabetes or HIV or the cause is unclear.
 
He added, "There is a high likelihood we could still help these patients, even though at the moment there are not clear diagnostic criteria or even a recognized syndrome known as COVID peripheral neuropathy.”
 
The study team surveyed patients who were tested for COVID-19 on the Washington University Medical Campus from March 16, 2020, through Jan. 12, 2021. Of the 1,556 study participants, 542 had positive COVID-19 tests, and 1,014 tested negative.
 
Dr Haroutounian said that many of those who tested negative were tested because they were undergoing surgery or were already hospitalized with cancer, diabetes or other health problems. Because of those existing health problems, many who tested negative already experienced chronic pain and neuropathy unrelated to COVID-19.
 
It was found that participants in the study who tested positive tended to be healthier and younger, and 29% reported symptoms of neuropathy at the time of their diagnosis. That compared to neuropathy problems in about 13% of the participants who tended to have health challenges but tested negative for COVID-19. He said this finding strengthens the possibility that the virus may be involved in causing symptoms of peripheral neuropathy.
 
As a result of the study being conducted at a single center, Dr Haroutounian said more research will be needed to replicate the findings.
 
Furthermore, much of the data was gathered when outpatient clinical research had been halted due to the pandemic, meaning that study patients were evaluated according to their responses to a survey rather than via in-person interviews and physical exams.
 
Dr Haroutounian further added, "We also finished our data collection before vaccinations became widespread and before the delta or omicron variants arrived, and it's difficult to say what effects those variables may have. So we want to follow up with some of those patients who have lingering nerve symptoms and learn about what is causing their pain so that we can better diagnose and treat these patients moving forward."
 
Thailand Medical News had also reported on another study findings earlier this month by researchers from Harvard that also showed that most recovered COVID-19 infected individuals with prolonged long COVID conditions are most likely to develop peripheral neuropathy.
https://www.thailandmedical.news/news/harvard-study-shows-that-those-with-prolonged-long-covid-will-likely-suffer-from-nerve-damage-and-peripheral-neuropathy
 
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