Comparison of Peripheral Nerve Injury Outcomes Between COVID-19 Survivors and Non-COVID Rehabilitation Inpatients: A Retrospective Study

Introduction: Peripheral nerve injury (PNI) is associated with severe Coronavirus disease 2019 (COVID-19) survivorship. The diagnosis of PNI is often made by a physiatrist 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 not known if the functional prognosis from PNI in COVID-19 survivors differs substantially from PNI in other inpatient rehabilitation populations. Objective: To determine the prognosis of PNI associated with severe COVID-19 survivorship and compare it to PNI associated with other inpatient rehabilitation populations. Design: Retrospective chart review study. Setting: Single-center inpatient rehabilitation hospital in a large urban city. Patients: Adult patients admitted to an inpatient rehabilitation hospital with PNI(s). Interventions: Not applicable. Main Outcome Measures: 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. Results: The analysis consisted of 60 subjects with PNI. We identified 30 subjects who had PNI associated with COVID-19 and were matched with 30 subjects with PNI not associated with COVID-19 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, and change in serial MMT, plus documentation of any surgical intervention. No significant difference was found between the improvement of MMT, surgery rate, or number of nerve injuries and COVID-19 status. Conclusion: 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.