Does nerve damage contribute to long-Covid symptoms?

Some patients with long-Covid have long-lasting nerve damage that appears caused by infection-triggered immune dysfunction, according to a study. Typical symptoms of neuropathy nerve damage include weakness, sensory changes, and pain in the hands and feet as well as internal complaints including fatigue, found researchers from Massachusetts General Hospital (MGH) and the National Institutes of Health.

The study, published in the journal Neurology: Neuroimmunology and Neuroinflammation, included 17 patients with Covid (16 with mild cases). Evaluations revealed evidence of peripheral neuropathy in 59 per cent. "This is one of the early papers looking into causes of long-Covid, which will steadily increase in importance as acute Covid wanes," said lead author Anne Louise Oaklander, an investigator in the Department of Neurology at MGH.

"Our findings suggest that some long-Covid patients had damage to their peripheral nerve fibers, and that damage to the small-fibre type of nerve cell may be prominent," she added. Oaklander noted that if patients have long-Covid symptoms that aren't otherwise explained and aren't improving, they might benefit from discussing neuropathy with their doctor or seeing a neurologist or neuromuscular specialist.

"Research from our team and others is clarifying what the different types of post-Covid neuropathy are, and how best to diagnose and treat them," Oaklander said. "Most long-Covid neuropathies described so far appear to reflect immune responses to the virus that went off course. And some patients seem to improve from standard treatments for other immune-related neuropathies."

However, she cautioned that there hasn't been enough time to conduct clinical trials to rigorously test specific treatments. Some people infected with the Covid-19 virus continue to experience long-Covid Symptoms persisting at least three months after recovery from the infection, even after mild cases.

These include difficulty getting through normal activities, faintness and rapid heart rate, shortness of breath, cognitive difficulties, chronic pain, sensory abnormalities, and muscle weakness.