Conference 2021 Live Talk

 

Talk title

Uncommon consequences of SARS-CoV-2 on the nervous system

 

Authors and Affiliations

Natalie Perez-Mendez1, Martha M. Rodriguez M.D.2

1. Poznań University of Medical Sciences, Poznań, Poland
2. MMR Healthcare, Internal Medicine Private Practice, Boynton Beach, United States

 

Abstract

Background

The scientific community is still trying to answer many questions that remain regarding the clinical sequelae of COVID-19. The purpose of this case report is to present a case of a healthy individual who now suffers from new-onset neurological symptoms since obtaining Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) infection and how it may warrant further investigation into how and why the novel coronavirus infiltrates nervous tissue.

Methods

A 52-year-old female with no prior history of nervous system pathology presented to our outpatient clinic with intermittent neuropathy, intermittent amnesia, hair loss, and intermittent rash after having COVID-19. The patient first complained only of chest tightness, fever, and shortness of breath during the initial telemedicine encounter. She was prescribed a one week course of oral prednisone followed by dexamethasone intramuscular injections daily for 2 weeks. Approximately 2 months later, after the resolution of the respiratory symptoms and testing negative for SARS-CoV-2 (RNA, Qualitative NAAT) twice, the patient returned to the clinic complaining of severe muscle aches, sciatica-like pain down both lower extremities, and nerve-impingement pain starting at the neck radiating along both upper extremities. She also complained of intermittent amnesia, chronic fatigue, hair loss, and dermatitis affecting the upper arms and waist.

Results

The aforementioned symptoms were refractory to oral NSAIDs and topical diclofenac. It was then decided to try cyanocobalamin intramuscular injections. This resolved much of the patient’s symptoms for several days, but they did eventually return. The injection was administered again and the patient’s symptoms resolved. Therefore, it was decided to administer 1000 mcg of cyanocobalamin to the patient every other day which has allowed her to return to normal daily lifestyle functioning

Conclusions

Nervous system consequences are generally overlooked when managing patients with COVID-19. Here we offer evidence that new-onset neurological symptoms may be debilitating byproducts of SARS-CoV-2 possible attack on the nervous system. Based on our patient’s positive response to regular cyanocobalamin injections, we believe further research is warranted to investigate its role as a potential part of the therapeutic regimen of COVID-19 in the outpatient setting.