Ultrasound-based Neuropathy Diagnosis in COVID-19 Patients in Post-intensive Care Rehabilitation Settings: A Retrospective Observational Study.
Susanna Zavaroni, Isabella Tristano, Vittoria Casamenti and 11 others
PMID 36854349WHAT IT FOUND
Ultrasound scans of the common fibular nerve showed a larger nerve size in patients with severe foot drop compared to those with mild weakness.
A cross-sectional area above 0.20 cm2 was proposed as a potential screening threshold for nerve injury in post-ICU patients.
Key findings
01Patients with severe foot weakness (MRC score below 3) had a significantly larger common fibular nerve cross-sectional area on ultrasound compared to those with mild or normal weakness.
02The study suggests a cut-off value of 0.20 cm2 for the nerve's cross-sectional area to help screen for common fibular neuropathy.
03Nerve swelling was not correlated with the patient's BMI or the number of days spent in the ICU.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study included only 26 patients, which is a very small sample size for establishing diagnostic cut-offs. The design was retrospective and observational, meaning it cannot prove that nerve swelling caused the weakness or that it predicts outcomes. There was no control group of patients with common fibular neuropathy who did not have a history of critical illness. Data collection occurred during rehabilitation, not in the ICU, so it is unclear if these ultrasound findings are present early enough to guide acute positioning decisions.
Declared interests
No specific conflicts of interest or funding sources are declared in the provided text.
The easy way to misread this
Do not adopt the 0.20 cm2 cut-off as a standard diagnostic rule. This value was derived from a small group of 26 patients in a rehabilitation setting, not a large diverse population, and the authors explicitly state that larger studies are needed to confirm it.