The prolonged mechanical ventilation that is often required by patients with severe COVID-19 is expected to result in significant intensive care unit-acquired weakness (ICUAW) in many survivors. However, the authors of this paper reported that, in their post-COVID-19 follow-up clinic, they found that, as well as the anticipated global weakness related to loss of muscle mass, a significant proportion of patients also had disabling focal neurological deficits relating to multiple axonal mononeuropathies. Amongst 69 patients with severe COVID-19 discharged from intensive care units, the authors saw 11 individuals (16%) with mononeuritis multiplex. In many instances, the multi-focal nature of the weakness in these patients was initially unrecognised as symptoms were wrongly assumed to relate simply to “critical illness neuromyopathy”. The authors concluded that, while mononeuropathy is well recognised as an occasional complication of intensive care, their experience suggests that such deficits are surprisingly frequent and often disabling in patients recovering from severe COVID-19.
DOI: https://doi.org/10.1007/s00415-020-10321-8