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Journal Review: Persistent post-COVID-19 neuromuscular symptoms
Journal Review: Persistent post–COVID-19 neuromuscular symptoms

Neuromuscular symptoms may develop or persist after resolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Besides residual sensorimotor symptoms associated with acute neuromuscular complications of coronavirus disease-2019 (COVID-19), such as Guillain–Barré syndrome, critical illness neuromyopathy, and rhabdomyolysis, patients may report persistent autonomic symptoms, sensory symptoms, and muscle symptoms in the absence of these acute complications, including palpitations, orthostatic dizziness and intolerance, paresthesia, myalgia, and fatigue. These symptoms may be associated with long COVID, also known as post–COVID-19 conditions or postacute sequelae of SARS-CoV-2 infection, which may significantly impact quality of life. Managing these symptoms represents a challenge for health-care providers. Recent advances have identified small-fiber neuropathy as a potential etiology that may underlie autonomic dysfunction and paresthesia in some long COVID patients. The pathogenic mechanisms underlying myalgia and fatigue remain elusive and need to be investigated. Herein we review the current state of knowledge regarding the evaluation and management of patients with persistent post–COVID-19 neuromuscular symptoms.

1)Learn to look for and query patients about autonomic and sensory symptoms as persistent post-COVID-19 neuromuscular symptoms;
2) Learn to look for and query patients about myalgia and fatigue as persistent post-COVID-19 neuromuscular symptoms; 
3) Be able to manage chronic neuromuscular symptoms after COVID-19 infection.  

The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The AANEM designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit expires 9/7/2026.

Authors had no conflicts to disclose.

Rory M. C. Abrams MD; Lan Zhou MD, PhD; Susan C. Shin MD
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Expires on Sep 07, 2026
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