Overcoming Neuromuscular Sequelae After Severe SARS-CoV-2 Infection: A Case Report

• Autor(a) principal: Almeida, Gabi
• Data de Publicação: 2023
• Outros Autores: Rocha-Melo, Jorge; Serviço de Medicina Física e de Reabilitação, Centro Hospitalar de Trás-os-Montes e Alto Douro, Portugal, Amorim, Edgar; Serviço de Medicina Física e de Reabilitação, Hospital de Braga, Portugal, Ribeiro, Sofia; Serviço de Medicina Física e de Reabilitação, Hospital de Braga, Portugal, Raposo, Ana Rita; Serviço de Medicina Física e de Reabilitação, Hospital de Braga, Portugal, Cruz, Cristina Miranda; Serviço de Medicina Física e de Reabilitação, Hospital de Braga, Portugal
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.25759/spmfr.470
• topic: COVID-19/complications; Muscle Weakness/ rehabilitation; Neurologic Manifestations/rehabilitation; Post- Acute COVID-19 Syndrome; SARS-CoV-2; COVID-19/complicações; Fraqueza Muscular/reabilitação; Manifestações Neurológicas/ reabilitação; SARS-CoV-2; Síndrome Pós-COVID-19 Aguda

Neurologic symptoms can occur in up to 65% of COVID-19 cases. This article aims to raise awareness to such neurologic impairments. We describe the case of a 52-year-old patient who required intubation and mechanical ventilation due to severe SARS-CoV-2 infection with acute respiratory distress syndrome. After extubation, he presented tetraparesis, with plegic right upper limb, global weakness of the left upper limb, and lower limb proximal weakness without distal muscle activation. Deep tendon reflexes were either decreased or absent. Right upper limb tactile and algic hypoesthesia and distal hyperesthesia in both lower limbs were also noticed. Following extensive investigation, intensive care unit-acquired weakness and right brachial plexus injury were diagnosed. He was engaged in a rehabilitation program and showed slow yet progressive improvement. At one-year follow-up evaluation, he was capable of performing independent gait with bilateral foot-up orthosis and used a tripod for unstable floorings, but maintained a non-functional right upper limb. This article describes multiple neurologic sequelae seen in a patient with severe SARS-CoV-2 infection after Intensive Care Unit hospitalization. Neurologic involvement associated to SARS-CoV-2 infection and its respective therapeutic management must be taken into account early on by medical teams and rehabilitation care should be offered.