Electrodiagnostic findings in COVID-19 patients: A single center experience

Hameed, Sajid; Farooq, Ayisha; Khan, Sara

OBJECTIVE: Neurological manifestations in patients with coronavirus disease 2019 (COVID-19) have been reported from early features of anosmia and dysgeusia to widespread involvement of the central nervous system, peripheral nervous system, as well as the neuromuscular junction and muscle. Our study objective is to evaluate the electromyography and nerve conduction study (EMG/NCS) findings among COVID-19 patients and look for possible correlations. METHODS: This is a hospital-based retrospective observational study. All COVID-19 patients between the period of 1st January 2020 to 31st December 2020 undergoing an EMG/NCS were included. RESULTS: Eighteen patients (12 male and 6 female) were included. Mean age was 55 ±12 years. 11 patients required intubation for a mean period of 18.6 days (range: 3-37 days). Electrodiagnostic findings were consistent with a myopathy in a majority of these patients (82%). Five of them also had a concurrent axonal neuropathy. In the remaining patients who did not require intubation (n=7), three patients had myopathic EMG changes and one had Guillain Barre syndrome. CONCLUSION: At this time, there are no neuromuscular-specific recommendations for patients who contract COVID-19. Only time and additional data will unveil the varying nature and potential neurological sequelae of COVID-19. SIGNIFICANCE: Myopathic EMG changes are commonly seen in critically ill COVID-19 patients, especially with a prolonged hospital stay. Abbrevations AIDP, Acute idiopathic demyelinating polyneuropathy; AMAN, Acute motor axonal neuropathy; AMSAN, Acute motor sensory axonal neuropathy; CIM, Critical Illness myopathy; CIN, Critical illness neuropathy; CK, Creatine Kinase; CNS, Central nervous system; COVID-19, Coronavirus disease 2019; EMG, Electromyography; GBS , Guillain Barre syndrome; NCS, Nerve conduction study; PNS, Peripheral nervous system; SNAP, Sensory nerve action potential