Evidence map›Paper›PMID 36513302›Full record

ArticleWorld neurosurgery2023

Upper Extremity Neuropathies Following Severe COVID-19 Infection: A Multicenter Case Series.

Neill Y Li, Nikhil K Murthy, Collin K Franz, Robert J Spinner, Allen T Bishop, Peter M Murray, Alexander Y Shin

Open access · greenAbstract readMulticenter Study
In one paragraph

Article in World neurosurgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Neill Y LiDepartment of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Nikhil K MurthyMcGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Collin K FranzShirley Ryan Ability Lab, Chicago, Illinois, USA; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; The Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Robert J SpinnerDepartment of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
Allen T BishopDepartment of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Peter M MurrayDepartment of Orthopaedic Surgery, Mayo Clinic, Jacksonville, Florida, USA.
Alexander Y ShinDepartment of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: shin.alexander@mayo.edu.
Mayo Clinic · USNorthwestern University · USJacksonville College · US

Funding

Northwestern University Clinical and Translational Science Institute (NUCATS)UL1TR001422 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI D'AQUILA, RICHARD · 2015 to 2023
$56.8M
NCATS NIH HHS UL1 TR001422
6 · The paper itself

Abstract

objectiveThe purpose of the study is to examine presentation, injury patterns, and clinical course, for COVID-19-related peripheral nerve injury following mechanical ventilation.

methodsA multicenter retrospective study of patients with COVID-19 complicated by acute respiratory distress syndrome (ARDS) that required mechanical ventilation was undertaken. Patient records were reviewed for intensive care unit and intubation characteristics, prone or lateral decubitus positioning, and the onset of neuropathy diagnosis.

resultsBetween September 2020 and January 2022, 11 patients were diagnosed with peripheral neuropathy, including 9 with brachial plexopathy following COVID-19 infection. Each patient developed ARDS requiring mechanical ventilation for a median of 39 days. Six patients (54.5%) underwent prone positioning and 1 lateral decubitus. Neuropathies involved 5 brachial pan-plexopathies, 2 incomplete brachial plexopathies, 2 lower trunk plexopathies, 1 radial neuropathy, and 1 bilateral ulnar neuropathy. At a mean follow-up of 10.2 months, patients with brachial pan-plexopathies demonstrated signs of reinnervation proximally, and 1 resolved to a radial mononeuropathy; however, the majority have demonstrated minimal clinical improvements.

conclusionsOur series demonstrates that peripheral neuropathies and especially brachial plexopathies have occurred following mechanical ventilation for ARDS-related COVID-19 infections. Contrary to prior COVID-19 studies, only 54.5% of these patients underwent prone positioning. Aside from a traumatic disturbance of prone positioning, the increased incidence of neuropathy may involve an atraumatic effect of COVID-19 via direct invasion of nerves, autoantibody targeting of nervous tissue, or hypercoagulation-induced microthrombotic angiopathy.

Indexed as

Brachial Plexus NeuropathiesCOVID-19Respiratory Distress SyndromeHumansProne PositionRetrospective StudiesUpper ExtremityAcute respiratory distress syndromeBrachial plexusCOVID-19Prone positioningUpper extremity neuropathy

Identifiers

PMID36513302
PMCPMC9737497
OpenAlexW4311255820

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.