Evaluation of Resstless Legs Syndrome in COVID-19 Patients

Abstract

Objective: During the COVID-19 pandemic, there have been case reports of restless legs syndrome (RLS) as well as many neurological diseases. COVID-19 disease causes sleep and movement disorders including RLS. The aim of our study is to evaluate the frequency of RLS in patients admitted to the COVID-19 outpatient clinic and to determine whether there is an increase in COVID-19 patients. Materials and Methods: Adult patients who applied to the COVID Outpatient Clinic were invited for cross-sectional descriptive research. The patients were asked to fill out a questionnaire for the diagnosis of RLS. Revised diagnostic criteria prepared by the International RLS Working Group were used for the diagnosis of RLS. Results: Out of 440 participants, 232 were male and 208 were female. 33 (11.0%) of 301 patients whose applications were based on any complaint had evaluated as RLS. Rates of RLS were not significantly different according to RT-PCR test result. Conclusion: Although RLS case reports have been made in COVID-19 disease, there are no large prospective studies. In this study, although we detected patients with RLS in COVID-19 outpatient clinic admissions, we found that the frequency of RLS was not different in patients who were shown to have COVID-19 by RT-PCR test. This result was interpreted as RLS complaints, which may occur with viral upper respiratory tract infections, are not specific to COVID-19.

Keywords

• COVID-19
• restless legs syndrome
• RT-PCR test

COVID-19 Hastalarında Huzursuz Bacak Sendromunun Değerlendirilmesi

Abstract

Giriş ve Amaç: COVID-19 pandemisi sürecinde birçok nörolojik hastalık yanında birlikte huzursuz bacak sendromu olan vaka bildirimleri de olmuştur. COVID-19 hastalığı uyku ve hareket bozukluğu hastalıklarına sebep olmaktadır. Çalışmamızın amacı COVID-19 polikliniğine başvuran hastalarda huzursuz bacak sendromu (HBS) sıklığını değerlendirip, COVID-19 hastalarında artma olup olmadığını belirlemektir. Gereç ve Yöntemler: Kesitsel tanımlayıcı araştırma için COVID Polikliniğine başvuran yetişkin hastalar davet edilmiştir. Hastalara HBS tanısına yönelik soru formu doldurtulmuştur. HBS tanısı için Uluslararası HBS Çalışma Grubu tarafından hazırlanan revize tanı kriterleri kullanılmıştır. Bulgular: 440 katılımcıdan 232’si erkek, 208’i kadındı. Başvuruları herhangi bir şikayete dayalı olan 301 hastadan 33’ünde (%11,0) HBS bulunduğu değerlendirildi. HBS oranları RT-PCR test sonucu açısından anlamlı farklı değildi. Sonuç: COVID-19 hastalığında HBS vaka bildirimleri yapılmış olmasına rağmen geniş prospektif çalışma bulunmamaktadır. Bu çalışmada COVID-19 polikinik başvurularında HBS olan hastalar saptamamıza rağmen HBS sıklığının RT-PCR testi ile COVID-19 olduğu gösterilen hastalarda farklı olmadığını bulduk. Bu sonuç viral üst solunum yolu enfeksiyonları ile birlikte ortaya çıkabilen HBS şikayetlerinin COVID-19’a özgü özellik göstermediğini şeklinde yorumlanmıştır.

Keywords

• COVID-19
• huzursuz bacak sendromu
• RT-PCR testi

References

1. Allen, R.P, Picchietti, D.L, Garcia-Borreguero, D, et al, Restless legs syndrome / Willis- Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria-history, rationale, description, and significance, Sleep Medicine, 2014, 15(8), 860-873.
2. Cuellar, N.G, Strumpf, N.E, Ratcliffe, S.J, Symptoms of restless legs syndrome in older adults: outcomes on sleep quality, sleepiness, fatigue, depression, and quality of life, Journal of the American Geriatrics Society, 2007, 55(9), 1387–1392.
3. Pearson, V.E, Allen, R.P, Dean, T, Gamaldo, C.E, Lesage, S.R, Earley, C.J, Cognitive deficits associated with restless legs syndrome (RLS), Sleep Medicine, 2006, 7(1), 25–30.
4. Phillips, B, Young, T, Finn, L, Asher, K, Hening, W.A, Purvis, C, Epidemiology of restless legs symptoms in adults, Archives of Internal Medicine, 2000, 160(14), 2137–2141.
5. Happe, S, Kundmüller, L, Reichelt, D, Husstedt, I.W, Evers, S, Comorbidity of restless legs syndrome and HIV infection, Journal of Neurology, 2007, 254(10), 1401–1406.
6. Tony, A.A, Tony, E.A.E, Ali S.B, Ezzeldin, A.M, Mahmoudi A.A, COVID-19-associated sleep disorders: A case report, Neurobiology of Sleep and Circadian Rhythms, 2020, 9, 100057.
7. Weinstock, L.B, Walters, A.S, Paueksakon, P, Restless legs syndrome – theoretical roles of inflammatory and immune mechanisms, Sleep Medicine Reviews, 2011, 16(4), 341–354.
8. Allen, R.P, Early, C.J, Restless legs syndrome: a review of clinical and pathophysiologic features, Journal of Clinical Neurophysiology, 2001, 18(2), 128-147.

9. Ibarra-Coronado, E.G, Pantaleón-Martínez, A.M, Velazquéz-Moctezuma, J, Prospéro-García, O, Méndez-Díaz, M, Pérez-Tapia, M, Pavón, L, Morales-Montor, J, The bidirectional relationship between sleep and immunity against infections, Journal of Immunology Research, 2015, 2015, 678164.
10. Fang, J, Tooley, D, Gatewood, C, Renegar, K.B, Majde, J.A, Krueger, J.M, Differential effects of total and upper airway influenza viral infection on sleep in mice, Sleep, 1996, 19(4), 337–342.
11. Toth, L.A, Williams, R.W, A quantitative genetic analysis of slow-wave sleep and rapid-eye movement sleep in CXB recombinant inbred mice, Behavior Genetics, 1999, 29(5), 329–337.
12. Silva, T.M.E, Moreira, G.A, Quadros, A.A.J, Pradella-Hallinan, M, Tufik, S, Oliveira, A.S.B, Analysis of characteristics in post-polio syndrome patients, Arquivos de Neuro-Psiquiatria, 2010, 68(4), 535–540.
13. Patton, S.M, Ponnuru, P, Snyder, A.M, Podskalny, G.D, Connor, J.R, Hypoxia-inducible factor pathway activation in restless legs syndrome patients, European Journal of Neurology, 2011, 18(11), 1329-1335.
14. Clardy, S.L, Wang, X, Boyer, P.J, Earley, C.J, Allen, R.P, Connor, J.R, Is ferroportin hepcidin signaling altered in restless legs syndrome? Journal of the Neurological Sciences, 2006, 247(2), 173-179.
15. Ganz, T, Hepcidin and its role in regulating systemic iron metabolism, Hematology. American Society of Hematology. Education Program, 2006, 29-35, 507.
16. Li, T, Lu, H, Zhang, W, Clinical observation and management of COVID-19 patients, Emerging Microbes & Infections, 2020, 9(2), 687-690.
17. Huang, C, Wang, Y, Li, X, et al, Clinical features of patients infected with 2019 novel corona virus in Vuhan, China, Lancet, 2020, 395(10223), 497-506.
18. Happe, S, Kundmüller, L, Reichelt, D, Husstedt, I.W, Evers, S, Comorbidity of restless legs syndrome and HIV infection, Journal of Neurology, 2007, 254(10), 1401-1406.
19. Allen, R.P, Controversies and challenges in defining the etiology and pathophysiology of restless legs syndrome, The American Journal of Medicine, 2007, 120(1 Suppl 1), S13-S21