Comparison of Peripheral Nerve Injury Outcomes Between COVID-19 Survivors and Non-COVID Rehabilitation Inpatients: A Retrospective Study

Abstract

Introduction: Peripheral nerve injury (PNI) is associated with severe Coronavirus disease 2019 (COVID-19) survivorship. The diagnosis of PNI is often made by a physiatrist during a detailed functional assessment during an inpatient rehabilitation stay. COVID-19 patients have elevated rates of medical comorbidities, including risk factors for acquired PNI, such as diabetes mellitus and obesity. It is not known if the functional prognosis from PNI in COVID-19 survivors differs substantially from PNI in other inpatient rehabilitation populations. Objective: To determine the prognosis of PNI associated with severe COVID-19 survivorship and compare it to PNI associated with other inpatient rehabilitation populations. Design: Retrospective chart review study. Setting: Single-center inpatient rehabilitation hospital in a large urban city. Patients: Adult patients admitted to an inpatient rehabilitation hospital with PNI(s). Interventions: Not applicable. Main Outcome Measures: The primary outcome was the change in manual muscle testing (MMT) over time. Secondary outcomes included the rate of peripheral nerve surgery and the number of distinct PNI sites per patient. Results: The analysis consisted of 60 subjects with PNI. We identified 30 subjects who had PNI associated with COVID-19 and were matched with 30 subjects with PNI not associated with COVID-19 who were diagnosed during their inpatient rehabilitation admission. The data collected included basic demographics, COVID-19 status immediately before inpatient rehabilitation admission, medical comorbidities, acute rehabilitation inpatient diagnosis, nerve injury location and mechanism of injury, muscles affected, and change in serial MMT, plus documentation of any surgical intervention. No significant difference was found between the improvement of MMT, surgery rate, or number of nerve injuries and COVID-19 status. Conclusion: PNIs associated with severe COVID-19 survivorship have similar recovery patterns as those of other etiologies. This data is reassuring that PNI associated with COVID-19 may be managed similarly to other types of PNI.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

Shirley Ryan Ability Lab externship program and Belle Carnell Regenerative Neurorehabilitation Fund

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study received approval from Northwestern University's Institutional Review Board (IRB) under approval number STU00219334. This included a waiver of informed consent, justified by the minimal risk to subjects and the impracticality of obtaining consent for this review. The IRB's approval ensured compliance with ethical principles, including patient privacy and data confidentiality, in line with the Declaration of Helsinki. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

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Data Availability

All data produced in the present study are available upon reasonable request to the authors

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