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 and 15 others
PMID 36209094WHAT IT FOUND
In 34 severe COVID-19 survivors, focal nerve injuries were found at sites vulnerable to compression, especially ulnar, fibular and sciatic nerves.
A wireless elbow pressure sensor was tested in 2 ICU patients and recorded pressure at different positions.
Key findings
01The 34 new cases had 66 peripheral nerve injuries, averaging 1.9 per patient, with common fibular, ulnar and sciatic sites most frequent.
02Across 92 patients from the new cases and prior case series, 183 peripheral nerve injuries were recorded, with ulnar the most common site at 25.1%.
03In 2 ICU patients, the sensor recorded elbow pressures of 44.9 mmHg on the left and 41.7 mmHg on the right during self-proning, and 4.5 mmHg in a position described as protecting the ulnar nerve.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This was a retrospective chart review of 34 new cases, with no control group, so it cannot show that COVID-19 or any specific ICU treatment caused the nerve injuries. ICU course details were missing for 27 of 34 patients because they were diagnosed in rehabilitation hospitals rather than acute care hospitals, so positioning or treatment exposures could not be linked to injury. Only more severe injuries may have been tested, because patients with milder nerve injuries might not have had nerve testing or imaging, which could underestimate incidence and bias toward severe cases. The pressure sensor was tested in only 2 patients, so it shows feasibility and real-time readings, not that it prevents nerve injury or improves outcomes. The 10.7% figure comes from one rehabilitation center's admission groups and nerve testing lab findings, so it is not a general incidence for all hospitals.
The easy way to misread this
Do not conclude that the pressure sensor prevents nerve injury. It was tested in only 2 patients, and the study had no control group or causal analysis.