The distribution of acquired peripheral nerve injuries associated with severe COVID-19 implicate a mechanism of entrapment neuropathy: a multicenter case series and clinical feasibility study of a wearable, wireless pressure sensor

Colin K Franz; Nikhil K Murthy; George R Malik; Jean W Kwak; Dom D'Andrea; Alexis R Wolfe; Ellen Farr; Melanie A Stearns; Swati Deshmukh; Jinny O Tavee; Fang Sun; Kevin N Swong; Leslie Rydberg; R James Cotton; Lisa F Wolfe; James M Walter; John M Coleman 3rd; John A Rogers

doi:10.1186/s12984-022-01089-1

The distribution of acquired peripheral nerve injuries associated with severe COVID-19 implicate a mechanism of entrapment neuropathy: a multicenter case series and clinical feasibility study of a wearable, wireless pressure sensor

J Neuroeng Rehabil. 2022 Oct 8;19(1):108. doi: 10.1186/s12984-022-01089-1.

Authors

Colin K Franz^{1

2

3

4}, Nikhil K Murthy^{5

6}, George R Malik⁷, Jean W Kwak^{8

9}, Dom D'Andrea¹⁰, Alexis R Wolfe^{5

11}, Ellen Farr¹², Melanie A Stearns¹³, Swati Deshmukh¹⁴, Jinny O Tavee¹⁵, Fang Sun¹⁶, Kevin N Swong⁶, Leslie Rydberg^{10

17}, R James Cotton^{10

17}, Lisa F Wolfe^{10

16

11}, James M Walter¹¹, John M Coleman 3rd^{16

11}, John A Rogers^{8

6

9

18

19

20

21}

Affiliations

¹ Shirley Ryan Ability Lab, 26-North, 355 E. Erie Street, Chicago, IL, 60611, USA. cfranz@sralab.org.
² Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. cfranz@sralab.org.
³ The Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. cfranz@sralab.org.
⁴ Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA. cfranz@sralab.org.
⁵ McGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁶ Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁷ Department of Physiatry, Hospital for Special Surgery, New York, NY, USA.
⁸ Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA.
⁹ Department of Mechanical Engineering, Northwestern University, Evanston, IL, USA.
¹⁰ Shirley Ryan Ability Lab, 26-North, 355 E. Erie Street, Chicago, IL, 60611, USA.
¹¹ The Division of Pulmonary and Critical Care, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
¹² Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
¹³ Marianjoy Rehabilitation Hospital, Northwestern Medicine, Wheaton, IL, USA.
¹⁴ Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
¹⁵ Division of Neurology & Behavioral Health, National Jewish Health, Denver, CO, USA.
¹⁶ The Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
¹⁷ Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
¹⁸ Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA.
¹⁹ Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA.
²⁰ Department of Chemistry, Northwestern University, Evanston, IL, USA.
²¹ Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, USA.

Abstract

We diagnosed 66 peripheral nerve injuries in 34 patients who survived severe coronavirus disease 2019 (COVID-19). We combine this new data with published case series re-analyzed here (117 nerve injuries; 58 patients) to provide a comprehensive accounting of lesion sites. The most common are ulnar (25.1%), common fibular (15.8%), sciatic (13.1%), median (9.8%), brachial plexus (8.7%) and radial (8.2%) nerves at sites known to be vulnerable to mechanical loading. Protection of peripheral nerves should be prioritized in the care of COVID-19 patients. To this end, we report proof of concept data of the feasibility for a wearable, wireless pressure sensor to provide real time monitoring in the intensive care unit setting.

Keywords: Brachial plexus; COVID-19; Intensive care unit; Neuromuscular; Neuropathy; Peripheral nerve injury; Rehabilitation; Wearable sensor.

Publication types

Multicenter Study

MeSH terms

Brachial Plexus* / injuries
COVID-19* / diagnosis
Feasibility Studies
Humans
Peripheral Nerve Injuries*
Wearable Electronic Devices*

Grants and funding

UL1 TR001422/TR/NCATS NIH HHS/United States