Post-COVID pain or weakness? Request an ultrasound or MRI

December 01, 2020

CHICAGO --- After recovering from COVID-19, some patients are left with chronic, debilitating pain, numbness or weakness in their hands, feet, arms and legs due to unexplained nerve damage. A new Northwestern Medicine study shows how advanced imaging technology can pinpoint what may have caused patients' nerve damage and help determine the best course of treatment.

"Let's say you have numbness in your fingers. That might actually be due to problems in your neck, elbow or wrist, and the best way to figure it out is with an MRI or ultrasound," said lead author Dr. Swati Deshmukh, assistant professor of radiology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine radiologist. "We offer advanced imaging that shows even really, really small nerves, which helps us localize where the problem is, assess the severity and suggest what might be causing it."

This is the first known publication to summarize how these advanced imaging techniques can help physicians identify and treat nerve damage in COVID-19 patients. The study will be published December 1 in the journal Radiology.

TWO NEW CAUSES OF NERVE DAMAGE

Previous research from Northwestern and Shirley Ryan AbilityLab found COVID-19 patients can experience nerve damage after being flipped onto their stomachs (prone positioning) in the ICU as a life-saving measure to help them breathe. This new paper demonstrates how advanced imaging aids this cohort of patients as well as two additional patient cohorts with COVID-19-related nerve damage: "Similar to how the body's immune response attacks the lungs in severe COVID cases, some patients have an immune response that affects their nerves," Deshmukh said. "Another group of patients developed hematomas as a complication from the blood thinners they were treated with when they had COVID."

Deshmukh said she hopes the findings will raise awareness of this imaging technology.

"I have to wonder if there are physicians out there who are seeing these otherwise young, healthy patients, and they don't know exactly what's wrong and they're thinking, 'What am I supposed to do for patients with post-COVID pain and weakness?'" Deshmukh said. "I want physicians and patients to be aware of the diagnostic options available due to recent innovations in technology, and inquire if advanced imaging might be right for them."

HOW THE TECHNOLOGY WORKS

The imaging described in the paper includes ultra-high-resolution ultrasound and MR neurography (MRI of peripheral nerves, which impact the arms and legs). They can help localize where a patient's problem is, show the severity of nerve damage, how many nerves are affected and if the nerve damage also has impacted the muscles.

The advanced ultrasound technology is new, portable, less expensive and can sometimes be even better at detecting nerve damage than MRI, Deshmukh said. Ultrasound also can be performed on patients who are unable to tolerate MR imaging.

GUIDING TREATMENT DECISIONS

If imaging technology discovers nerve damage caused by stretch injury because of prone positioning, Deshmukh said, that patient may be referred to a physician who specializes in rehabilitation or peripheral nerve surgery. If imaging finds nerve damage due to an inflammatory response, the patient may be better served by seeing a neurologist. If imaging reveals nerve damage from a hematoma, blood thinner medications would have to be adjusted immediately and the patient may even have to see a surgeon.

For COVID-19 patients and survivors with neuromuscular complications or "long-hauler" symptoms, imaging can help reveal the problem and guide further treatment.

All patients in the study had tested positive for COVID-19.
-end-
Other Northwestern study authors include Dr. Colin K. Franz , Dr. Jason H. Ko, Dr. James M. Walter and Dr. Igor J. Koralnik from the departments of physical medicine and rehabilitation, neurology, plastic and reconstructive surgery, and pulmonary and critical care, respectively.

Northwestern University

Related Immune Response Articles from Brightsurf:

Boosting chickens' own immune response could curb disease
Broiler chicken producers the world over are all too familiar with coccidiosis, a parasite-borne intestinal disease that stalls growth and winnows flocks.

Cells sacrifice themselves to boost immune response to viruses
Whether flu or coronavirus, it can take several days for the body to ramp up an effective response to a viral infection.

Children's immune response more effective against COVID-19
Children and adults exhibit distinct immune system responses to infection by the virus that causes COVID-19, a finding that helps explain why COVID-19 outcomes tend to be much worse in adults, researchers from Yale and Albert Einstein College of Medicine report Sept.

Which immune response could cause a vaccine against COVID-19?
Immune reactions caused by vaccination can help protect the organism, or sometimes may aggravate the condition.

Obesity may alter immune system response to COVID-19
Obesity may cause a hyperactive immune system response to COVID-19 infection that makes it difficult to fight off the virus, according to a new manuscript published in the Endocrine Society's journal, Endocrinology.

Immune response to Sars-Cov-2 following organ transplantation
Even patients with suppressed immune systems can achieve a strong immune response to Sars-Cov-2.

'Relaxed' T cells critical to immune response
Rice University researchers model the role of relaxation time as T cells bind to invaders or imposters, and how their ability to differentiate between the two triggers the body's immune system.

A novel mechanism that triggers a cellular immune response
Researchers at Baylor College of Medicine present comprehensive evidence that supports a novel trigger for a cell-mediated response and propose a mechanism for its action.

Platelets exacerbate immune response
Platelets not only play a key role in blood clotting, but can also significantly intensify inflammatory processes.

How to boost immune response to vaccines in older people
Identifying interventions that improve vaccine efficacy in older persons is vital to deliver healthy ageing for an ageing population.

Read More: Immune Response News and Immune Response Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.