Permanent Nerve Injuries in COVID-19 Ventilator Patients

Scientists believe that patients who require a ventilator may experience nerve damage which is a result of reduced blood flow and inflammation. This effect is strictly associated with COVID-19 patients only as other patients with ventilator requirements do not experience the same. Based on this study, 12% to 15% percent of the most severely ill COVID-19 patients have permanent nerve damage. Based on the number of COVID patients around the world, scientists estimated that thousands of patients have been impacted.

The injury has been missed because most people who have been critically ill are expected to wake up with some generalized, symmetric weakness because they have been bedridden. But the pattern of weakness in the COVID-19 patients caught the scientist’s attention during rehabilitation. It was found that often an important joint such as the wrist, ankle, or shoulder would be completely paralyzed on one side of the body. Taking the findings into consideration, physicians are modifying the prone position protocol for COVID-19 patients. They noticed a lot of pressure was at the elbow or the neck, so some adjustments were made to the way the joints were positioned as well as putting extra support under the elbow and the knee where there is the most pressure.

The most common injuries are wrist drops, foot drops, loss of hand function, and frozen shoulder. With on-going research on therapeutic nerve stimulation, in some cases, nerves are shown to re-grow. But many patients have pre-existing conditions that interfere with nerve regeneration, such as diabetes mellitus, so they are less likely to recover full function. This could mean permanent difficulties with walking or critical hand functions like writing or operating a computer or cell phone.

Ref link: https://www.medrxiv.org/content/10.1101/2020.07.01.20144436v1