In a new review study, researchers found two noteworthy findings related to COVID-19 and patients with neuromuscular disorders.
They found that the novel coronavirus can bring on neuromuscular conditions in patients who previously had none and that the virus can worsen symptoms in patients with pre-existing conditions and who are being treated with immunotherapies.
The research was conducted by a team at University at Buffalo.
In the study, the team reviewed studies mentioning COVID-19 and neuromuscular conditions published from the start of the pandemic and running through June 18, 2020—a total of 547 publications.
Although neuromuscular complications of COVID-19 have not received as much publicity as stroke complications, they are being increasingly reported.
Guillain-Barré syndrome (GBS), a severe life-threatening paralyzing neuropathy that is a complication of many viral infections, has now been seen in COVID-19 patients in many countries, including the United States.
The literature indicated that since the pandemic hit, 27 cases of Guillain-Barré syndrome stemming from the virus have been reported worldwide. Three of the cases were a variant of GBS, the Miller Fisher variant.
GBS cases were reported in Austria, China, France, Germany, Italy, Iran, Morocco, Spain, Switzerland, Turkey, and the U.S. Italy and the U.S. had the most reported cases, with 10 and four, respectively.
The mean age of the patients was 59.8; 63 percent were male. Forty-four percent of the patients—or 12—had to be ventilated.
The team showed that 16 of the patients, or 59%, demonstrated clinical improvement or achieved full or near full recovery, while nine, or 33.3%, did not show significant improvement or had a worsening clinical status.
The paper noted that of the 16 patients who improved, 14 were treated with intravenous immunoglobulin. Outcomes were not reported for the remaining two. No fatalities were reported.
Two other neuromuscular disorders, myopathy, and hyperCKemia, were reported complications of COVID-19 in the reviewed literature.
In myopathy, the patients’ muscle fibers do not function properly, resulting in weakness, cramps, stiffness, and spasms.
Patients with pre-existing neuromuscular disorders such as myasthenia gravis (MG) tend to be more vulnerable to infections like COVID-19, and the infection often exacerbated their conditions, the researchers reported.
In addition, immunotherapy treatments place these patients at greater risk of infection.
The literature suggests that MG patients may be at a higher risk for contracting COVID-19 and developing secondary complications.
The researchers concluded from their review that neuromuscular patients on immunotherapy and those with respiratory dysfunction secondary to their neuromuscular disease should be considered high risk for severe COVID -19 infection and complications.
These patients should be encouraged to notify their healthcare provider immediately if there are signs suspicious for COVID -19 infection.
One author of the study is Gil I. Wolfe, MD, Irvin and Rosemary Smith Professor.
The study is published in RRNMF Neuromuscular Journal.
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