4.5 Article

Complex regional pain syndrome after severe COVID-19-A case report

Journal

HELIYON
Volume 7, Issue 11, Pages -

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.heliyon.2021.e08462

Keywords

COVID-19; Critical care; Complex regional pain syndrome; Peripheral nerve injury; Case report

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Neurological complications in ICU patients with COVID-19, such as peripheral nerve lesions, can have various causes and may increase the risk of developing Complex Regional Pain Syndrome. A multidisciplinary approach for early diagnosis and treatment is crucial for intervention and prognosis of nerve injuries.
Neurological complications are frequently reported in an intensive care unit (ICU), as a manifestation of a critical systemic illness or of its treatment. On the specific setting of COVID-19 patients, peripheral nerve lesions can have a multiplicity of causes, such as post-infectious neuropathy, positioning-related neuropathy or iatrogeny. An unusual but potentially disabling complication of any peripheral nerve lesion is Complex Regional Pain Syndrome (CRPS). Although there have been no mechanistic studies assessing how SARS-CoV-2 might directly impact nociception, it is hypothesized that the systemic hyperinflammation seen in severe COVID-19 may contribute to peripheral and central neuronal sensitization, possibly increasing the risk of developing CRPS. This case report highlights the potential hazards and consequences of peripheral nerve injuries on an ICU setting in COVID-19 patients, as well as the importance of a multidisciplinary approach for an early diagnosis and treatment, which are directly related to a better prognosis.

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