Comparison of peripheral nerve injury outcomes between COVID-19 survivors and non-COVID rehabilitation inpatients: A retrospective study

Peripheral nerve injury (PNI) is associated with severe Coronavirus disease 2019 (COVID-19) survivorship. A physiatrist often diagnoses PNI 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 unknown if the functional prognosis from PNI in COVID-19 survivors differs substantially from PNI in other inpatient rehabilitation populations. This retrospective chart review study aimed to determine the prognosis of severe COVID-19 survivorship-associated PNI and compare it to PNI associated with other inpatient rehabilitation populations. 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. The analysis consisted of 60 subjects with PNI. Thirty subjects with PNI associated with COVID-19 were matched with 30 subjects with non-COVID-19 associated PNI 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, serial MMT change, and surgical intervention documentation. No significant difference was found between the improvement of MMT, surgery rate, or number of nerve injuries and COVID-19 status. 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.