ORIJINAL ARAŞTIRMA
COVID-19 Enfeksiyonu Sonrası Elektronörofizyoloji Laboratuvarına Yönlendirilen Hastaların Klinik Özellikleri: Retrospektif Analiz
Clinical Features of Patients Referred to an Electroneurophysiology Laboratory After COVID-19 Infection: Retrospective Analysis
Received Date : 16 Oct 2021
Accepted Date : 21 Jan 2022
Available Online : 26 Jan 2022
Selin ÖZENa, Oya ÜMİT YEMİŞCİa, Sacide Nur SARAÇGİL COŞARa
aDepartment of Physical and Rehabilitation Medicine, Başkent University Faculty of Medicine, Ankara, TURKIYE
Doi: 10.31609/jpmrs.2021-86658 - Makale Dili: EN
J PMR Sci. 2022;25(2):220-25
ÖZET
Amaç: Bu çalışmanın amacı, koronavirüs hastalığı-2019 [coronavirus
disease-2019 (COVID-19)] enfeksiyonu sonrası elektronöromiyografi
(ENMG) laboratuvarına refere edilen hastaların klinik
özelliklerinin değerlendirilmesidir. Gereç ve Yöntemler: 11 Mart
2020-11 Mart 2021 tarihleri arasında şiddetli akut solunum sendromu-
CoV-2 [severe acute respiratory syndrome-CoV-2 (SARS-CoV-2)] tanısı
alan ve sonrasında nöromusküler semptom ve bulguları olan, ENMG
laboratuvarına refere edilen hastaların, hastane dosyaları retrospektif olarak
tarandı. Hastaların demografik bilgileri, komorbiditeleri, şikâyetleri,
SARS-CoV-2 enfeksiyon tarihi, istenen elektrofizyolojik tetkik ve
ENMG sonuçları kaydedildi. Bulgular: Bin iki yüz yetmiş dört hasta
dosyası tarandı ve 62 hasta çalışmaya dâhil edildi [ortalama yaş:
50,39±17,2, %58,1 (n=36) erkek]. Hastalar, COVID-19 tanısını pandemi
başlangıcından itibaren ortalama 7,29±1,59 ay sonra almış olup, çoğu
yoğun bakımda tedavi edilmemişti (%95,2). Hastaların nöromusküler şikâyetleri,
COVID-19 enfeksiyonundan ortalama 2,65±1,86 ay sonra başlamıştı.
Sık görülen semptomlar, parestezi (%41,9) ve ekstremitelerde
ağrı (%17,7) idi. En sık görülen komorbiditeler arasında ise hipertansiyon
(%22,6) ve diabetes mellitus (%17,7) yer almaktaydı. Hastaların
%30,6’sında duyu bozukluğu, azalmış kas kuvveti ve derin tendon refleks
değişikliği saptandı. En sık ENMG tanısı, polinöropati idi (%22,5). Hastaların
%42,1’inde ise ENMG bulguları normal sınırlarda saptandı.
Sonuç: COVID-19, periferik sinir sistemi (PSS) dâhil birçok nörolojik
komplikasyona yol açabilmektedir. İlk elektrofizyolojik değerlendirmeler
normal saptansa bile devam eden PSS şikâyetleri olan hastalarda,
ENMG tekrarlanmalı ve daha duyarlı elektrofizyolojik testlerin de gerekliliği
dikkate alınmalıdır. Gelecekteki çalışmalarda, PSS patolojilerinin
oluşumunda SARS-CoV-2 enfeksiyonunun gerçek bir etkisi olup
olmadığı araştırılmalıdır.
Anahtar Kelimeler: SARS-CoV-2; elektromiyografi; polinöropatiler; periferik sinir sistemi
ABSTRACT
Objective: The aim of this study was to determine the
clinical features and electrophysiological diagnoses of patients referred
to the electroneuromyography (ENMG) laboratory after coronavirus
disease-2019 (COVID-19) infection. Material and Methods: Medical
records of patients referred to the ENMG laboratory between March
11, 2020 and March 11, 2021 with neuromuscular signs and symptoms,
preceded by a diagnosis of severe acute respiratory syndrome-CoV-2
(SARS-CoV-2), were reviewed retrospectively. Patient demographics,
comorbidities, presenting complaints, date of SARS-CoV-2 infection,
nature of electrophysiological investigation and ENMG outcomes were
recorded. Results: 1,274 medical records were reviewed, 62 patients
were included in the study. Mean age was 50.39±17.2 years, 36 (58.1%)
were male. The diagnosis of COVID-19 was made 7.29±1.59 months
after the onset of the pandemic and 95.2% did not require treatment in
the intensive care unit of the hospital. Patients presented with neuromuscular
complaints 2.65±1.86 months after COVID-19 diagnosis.
Common symptoms were paraesthesia (41.9%) and pain in the extremities
(17.7%). Hypertension (22.6%) and diabetes mellitus (17.7%)
were the most commonly reported comorbidities. Changes in sensation
and deep tendon reflexes and reduced muscle power were detected in
30.6%. Most common ENMG diagnosis was polyneuropathy (22.5%).
ENMG findings were normal in 42.1%. Conclusion: COVID-19 gives
rise to many neurological complications, including those involving the
peripheral nervous system (PNS). Repeat ENMG and further, more sensitive
electrophysiological testing should be considered in those with
continued PNS complaints, despite initially normal electrophysiological
findings. Further studies should establish whether SARS-CoV-2 infection
is causal or coincidental in the development of PNS pathologies
and related ENMG findings.
Keywords: SARS-CoV-2; electromyography; polyneuropathies; peripheral nervous system
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