Invited Review: Primary perineuritis, a rare but treatable neuropathy: Review of perineurial anatomy, clinicopathological features, and differential diagnosis-Article

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Neuromuscular symptoms can persist after recovery from COVID-19, causing significant impact on a patient's quality of life. These symptoms include autonomic symptoms, sensory symptoms, muscle symptoms, fatigue, and myalgia. Autonomic symptoms may manifest as palpitations, orthostatic dizziness, and intolerance, while sensory symptoms can include paresthesia and numbness. Small-fiber neuropathy has been identified as a potential underlying cause for these symptoms. Guillain-Barré syndrome (GBS) is a rare complication of COVID-19 that can lead to residual sensorimotor symptoms. Myalgia and fatigue are also common symptoms of long COVID, but their underlying mechanisms are not fully understood. Managing these persistent neuromuscular symptoms can be challenging, and an individualized approach is recommended. Evaluation should include a detailed history, physical examination, and laboratory tests to screen for underlying medical conditions. Electrodiagnostic studies may be performed to assess nerve and muscle function. Autonomic function testing and skin biopsy can help identify small-fiber neuropathy. Symptomatic treatment is the mainstay of management, although the use of immunomodulatory therapies like corticosteroids and intravenous immunoglobulin remains uncertain. Further research is needed to better understand the mechanisms underlying long COVID symptoms and develop targeted therapies.

Keywords

Neuromuscular symptoms

COVID-19 recovery

Quality of life

Autonomic symptoms

Sensory symptoms

Muscle symptoms

Fatigue

Myalgia

Small-fiber neuropathy

Guillain-Barré syndrome