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Pandemic experience of our electrophysiology laboratory

Year 2025, Volume: 6 Issue: 1, 9 - 13, 31.01.2025

Abstract

Objectives: Although the main symptoms of COVID-19 disease, which has caused serious effects worldwide, are fever and respiratory system findings, neurological involvement is common. Our study aimed to evaluate electromyography (EMG) and nerve conduction study (NCS) findings among COVID-19 patients, especially those with long-term hospitalizations, in whom neuromuscular symptoms were frequently reported, and to investigate the correlations between clinical diagnosis and electroneurophy-siological diagnosis.
Methods: This is a hospital-based retrospective observational study. Patients who were diagnosed with COVID-19 disease between March 2020 and March 2022 and sent to the electroneurophysiology labora-tory with neurological complaints and underwent nerve conduction study and EMG were included.
Results: Of the 60 patients, 26 were male and 34 were female. The mean age of the patients was 51.81±15.51 years. The mean time between COVID-19 diagnosis and EMG examination was 75.7±63.5 (15-240) days. Intensive care unit stay and mechanical ventilation requirement (3-36 days) were obser-ved in 15 patients (% 25). In 25 patients (% 41), preliminary diagnosis and EMG results were found to be compatible. Results of 25 patients were normal, 13 patients had sensory motor axonal polyneuro-pathy, 3 patients had acute polyneuropathy, 4 patients had myopathy, 3 patients had radiculopathy, 1 patient had inflammatory myopathy, 1 patient had newly diagnosed myasthenia gravis, and 10 patients had entrapment neuropathy findings.
Conclusion: Neurological involvement was shown in 1/3 of COVID-19 patients. Abnormalities were detected in EMG findings in 45 of 60 patients who were hospitalized due to COVID-19 and whose EMG tests were requested from our laboratory. However, critical illness neuropathy and myopathy were the most frequently reported in patients who required mechanical ventilation.

References

  • 1. WHO Coronavirus (COVID-19) Dashboard | WHO Coronavirus (COVID-19) Dashboard with Vaccination Data.
  • 2. Zubair AS, McAlpine LS, Gardin T, Farhadian S, Kuruvilla DE, Spudich S. Neuropathogenesis and Neurologic Manifestations of the Coronavi-ruses in the Age of Coronavirus Disease 2019: A Review JAMA Neurol. 2020 Aug 1;77(8):1018-1027.
  • 3. Harapan BN, Yoo HJNeurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coro-navirus 2 (SARS-CoV-2) and coronavirus dise-ase 19 (COVID-19). J Neurol. 2021; 268(9): 3059–3071.
  • 4. Mao L, Jin H, Wang M, Hu Yu, Chen S, He Q, Chang J, Hong C, Zhou Y, Wang D, Miao X, Li Y, Hu Bo. Neurologic manifestations of hospi-talized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 2020;77(6):683.
  • 5. Esposito S, Longo MR. Guillain-Barré sendro-mu . Otoimmün Rev. 2017; 16 :96–101.
  • 6. Sedaghat Z, Karimi N. Guillain Barre syndrome associated with COVID-19 infection: a case re-port. J Clin Neurosci. 2020;76:233–235. Lucchese G, Flöel A (2020) SARS-CoV-2 and Guillain-Barré syndrome: molecular mimicry with human heat shock proteins as potential pathogenic mechanism. Cell Stress Chapero-nes:1–5.
  • 7. Paybast S, Gorji R, Mayandadi S. Guillain-Barré Syndrome as a Neurological Complication of Novel COVID-19 Infection: A Case Report and Review of the Literature. Neurologist . 2020 Jul;25(4):101-103.
  • 8. Vanhorebeek I, Latronico N, Van den Berghe G. ICU-acquired weakness. Intensive Care Med. 2020;25(2):204–207.
  • 9. Kim JE, Heo JH, Kim HO, et al. Neurological complications during treatment of Middle East respiratory syndrome. J Clin Neu-rol. 2017; 13 :227–233.
  • 10. Ferrandi PJ, Alway SE, Mohamed JS. The inte-raction between SARS-CoV-2 and ACE2 may have consequences for skeletal muscle viral susceptibility and myopathies. 2020; J Appl Physiol.
  • 11. Borku Uysal B, Ikitimur H, Yavuzer S, Islamog-lu MS, Cengiz M. Case report: a COVID-19 pa-tient presenting with mild rhabdomyolysis. Am J Trop Med Hyg. 2020;103:847–850.
  • 12. Gefen AM, Palumbo N, Nathan SK, Singer PS, Castellanos-Reyes LJ, Sethna CB. Pediatric COVID-19-associated rhabdomyolysis: a case report. Pediatr Nephrol. 2020;35(8):1517–1520.
  • 13. Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a mul-ticenter European study. Eur Arch Otorhino-laryngol. 2020; 1–11.
  • 14. Assini A, Gandoglia I, Damato V, Rikani K, Evoli A, Del Sette M. Myasthenia gravis associ-ated with anti-MuSK antibodies developed af-ter SARS-CoV-2 infection. Eur J Neurol. 2021.
  • 15. Ramaswamy SB, Govindarajan R. COVID-19 in refractory myasthenia gravis-a case report of successful outcome. J Neuromuscul Dis. 2020;7(3):361–364.
  • 16. Hameed S, Khan AF,Khan S. Electrodiagnostic findings in A single center experience. Clin Ne-urophysiol. 2021.

Elektrofizyoloji laboratuvarımızın pandemi deneyimi

Year 2025, Volume: 6 Issue: 1, 9 - 13, 31.01.2025

Abstract

Amaç: Dünya genelinde ciddi bir etkilenmeye neden olan COVID-19 hastalığının temel belirtileri ateş ve solunum sistemi bulguları olsa da nörolojik tutulum yaygındır. Çalışmamızda özellikle uzun süreli hastane yatışlarında nöromüsküler belirtilerin sık rapor edildiği COVID-19 hastaları arasında elektro-miyografi (EMG) ve sinir iletim çalışması (NCS) bulgularını değerlendirmek ve klinik tanı ile elektronö-rofizyolojik tanı arasındaki korelasyonları araştırmak amaçlanmıştır.
Yöntem: Hastane temelli retrospektif gözlemsel bir çalışmadır. Mart 2020 ile Mart 2022 tarihleri arasın-daki COVID-19 hastalığı tanısı alıp nörolojik yakınmalarla elektronörofizyoloji laboratuvarına gönde-rilen sinir ileti çalışması ve EMG yapılan hastalar dahil edildi.
Bulgular: 60 hastanın 26’sı erkek ve 34’ü kadındı. Hastaların yaş ortalaması 51,81± 15,51 yıldı. COVID-19 tanısı ile EMG incelemesi arasındaki süre ortalaması 75,7 ± 63,5 (15- 240) gündü. 15 hasta-da (% 25) yoğun bakımda yatış ve mekanik ventilasyon ihtiyacı ( 3- 36 gün) gözledi. 25 hastada (%41) ön tanı ile EMG sonucu uyumlu saptandı. 25 hastanın sonucu normal, 13 hastada duyusal motor aksonal polinöropati, 3 hastada akut polinöropati, 4 hastada miyopati, 3 hastada radikülopati, 1 hastada inflamatuar miyopati, 1 hastada yeni tanı miyastenia gravis, 10 hastada tuzak nöropati bulguları saptandı.
Sonuç: COVID-19 hastalarının 1/3’ünde nörolojik tutulum gösterilmiştir. COVID-19’a bağlı yatışı olan ve EMG laboratuvarımızdan tetkik istenen 60 hastanın 45’inde EMG bulgularında anormallik saptandı.Ayrıca mekanik ventilasyon ihtiyacı olan hastalarda en sık kritik hastalık nöropatisi ve miyo-patisi görülmüştür.

References

  • 1. WHO Coronavirus (COVID-19) Dashboard | WHO Coronavirus (COVID-19) Dashboard with Vaccination Data.
  • 2. Zubair AS, McAlpine LS, Gardin T, Farhadian S, Kuruvilla DE, Spudich S. Neuropathogenesis and Neurologic Manifestations of the Coronavi-ruses in the Age of Coronavirus Disease 2019: A Review JAMA Neurol. 2020 Aug 1;77(8):1018-1027.
  • 3. Harapan BN, Yoo HJNeurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coro-navirus 2 (SARS-CoV-2) and coronavirus dise-ase 19 (COVID-19). J Neurol. 2021; 268(9): 3059–3071.
  • 4. Mao L, Jin H, Wang M, Hu Yu, Chen S, He Q, Chang J, Hong C, Zhou Y, Wang D, Miao X, Li Y, Hu Bo. Neurologic manifestations of hospi-talized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 2020;77(6):683.
  • 5. Esposito S, Longo MR. Guillain-Barré sendro-mu . Otoimmün Rev. 2017; 16 :96–101.
  • 6. Sedaghat Z, Karimi N. Guillain Barre syndrome associated with COVID-19 infection: a case re-port. J Clin Neurosci. 2020;76:233–235. Lucchese G, Flöel A (2020) SARS-CoV-2 and Guillain-Barré syndrome: molecular mimicry with human heat shock proteins as potential pathogenic mechanism. Cell Stress Chapero-nes:1–5.
  • 7. Paybast S, Gorji R, Mayandadi S. Guillain-Barré Syndrome as a Neurological Complication of Novel COVID-19 Infection: A Case Report and Review of the Literature. Neurologist . 2020 Jul;25(4):101-103.
  • 8. Vanhorebeek I, Latronico N, Van den Berghe G. ICU-acquired weakness. Intensive Care Med. 2020;25(2):204–207.
  • 9. Kim JE, Heo JH, Kim HO, et al. Neurological complications during treatment of Middle East respiratory syndrome. J Clin Neu-rol. 2017; 13 :227–233.
  • 10. Ferrandi PJ, Alway SE, Mohamed JS. The inte-raction between SARS-CoV-2 and ACE2 may have consequences for skeletal muscle viral susceptibility and myopathies. 2020; J Appl Physiol.
  • 11. Borku Uysal B, Ikitimur H, Yavuzer S, Islamog-lu MS, Cengiz M. Case report: a COVID-19 pa-tient presenting with mild rhabdomyolysis. Am J Trop Med Hyg. 2020;103:847–850.
  • 12. Gefen AM, Palumbo N, Nathan SK, Singer PS, Castellanos-Reyes LJ, Sethna CB. Pediatric COVID-19-associated rhabdomyolysis: a case report. Pediatr Nephrol. 2020;35(8):1517–1520.
  • 13. Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a mul-ticenter European study. Eur Arch Otorhino-laryngol. 2020; 1–11.
  • 14. Assini A, Gandoglia I, Damato V, Rikani K, Evoli A, Del Sette M. Myasthenia gravis associ-ated with anti-MuSK antibodies developed af-ter SARS-CoV-2 infection. Eur J Neurol. 2021.
  • 15. Ramaswamy SB, Govindarajan R. COVID-19 in refractory myasthenia gravis-a case report of successful outcome. J Neuromuscul Dis. 2020;7(3):361–364.
  • 16. Hameed S, Khan AF,Khan S. Electrodiagnostic findings in A single center experience. Clin Ne-urophysiol. 2021.
There are 16 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences (Other)
Journal Section Articles
Authors

İlknur Güçlü Altun 0000-0003-1558-6991

Ahmet Yıldırım 0000-0002-6644-9148

Rahşan Adviye İnan 0000-0002-6084-055X

Publication Date January 31, 2025
Submission Date October 11, 2024
Acceptance Date January 28, 2025
Published in Issue Year 2025 Volume: 6 Issue: 1

Cite

APA Güçlü Altun, İ., Yıldırım, A., & İnan, R. A. (2025). Elektrofizyoloji laboratuvarımızın pandemi deneyimi. Troia Medical Journal, 6(1), 9-13. https://doi.org/10.55665/troiamedj.1565462
AMA Güçlü Altun İ, Yıldırım A, İnan RA. Elektrofizyoloji laboratuvarımızın pandemi deneyimi. Troia Med J. January 2025;6(1):9-13. doi:10.55665/troiamedj.1565462
Chicago Güçlü Altun, İlknur, Ahmet Yıldırım, and Rahşan Adviye İnan. “Elektrofizyoloji laboratuvarımızın Pandemi Deneyimi”. Troia Medical Journal 6, no. 1 (January 2025): 9-13. https://doi.org/10.55665/troiamedj.1565462.
EndNote Güçlü Altun İ, Yıldırım A, İnan RA (January 1, 2025) Elektrofizyoloji laboratuvarımızın pandemi deneyimi. Troia Medical Journal 6 1 9–13.
IEEE İ. Güçlü Altun, A. Yıldırım, and R. A. İnan, “Elektrofizyoloji laboratuvarımızın pandemi deneyimi”, Troia Med J, vol. 6, no. 1, pp. 9–13, 2025, doi: 10.55665/troiamedj.1565462.
ISNAD Güçlü Altun, İlknur et al. “Elektrofizyoloji laboratuvarımızın Pandemi Deneyimi”. Troia Medical Journal 6/1 (January 2025), 9-13. https://doi.org/10.55665/troiamedj.1565462.
JAMA Güçlü Altun İ, Yıldırım A, İnan RA. Elektrofizyoloji laboratuvarımızın pandemi deneyimi. Troia Med J. 2025;6:9–13.
MLA Güçlü Altun, İlknur et al. “Elektrofizyoloji laboratuvarımızın Pandemi Deneyimi”. Troia Medical Journal, vol. 6, no. 1, 2025, pp. 9-13, doi:10.55665/troiamedj.1565462.
Vancouver Güçlü Altun İ, Yıldırım A, İnan RA. Elektrofizyoloji laboratuvarımızın pandemi deneyimi. Troia Med J. 2025;6(1):9-13.