Neuropathic pain post-COVID-19: a case report

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can present with a wide spectrum of clinical manifestations.
• Neurological complications of SARS-CoV-2 are increasingly reported, but their exact mechanisms and clinical patterns remain under investigation.

Observation:

• A 61-year-old man with no prior medical history developed fever, headache, and dyspnea, testing positive for SARS-CoV-2.
• One week post-diagnosis, he experienced severe, widespread burning pain, predominantly in his limbs, without ataxia or autonomic dysfunction.
• Standard neurological examinations, electrophysiological tests, skin biopsy, lumbar puncture, and advanced neuroimaging were unremarkable.

Findings:

• The patient's pain was initially refractory to pregabalin.
• A gradual reduction of steroid therapy led to significant pain improvement.
• This suggests a potential inflammatory or immune-mediated mechanism contributing to neuropathic pain post-SARS-CoV-2.

Implications:

• This case underscores the potential for SARS-CoV-2 to induce diverse and severe neuropathic pain syndromes.
• Further research is warranted to elucidate the pathophysiology of these neurological sequelae.
• Clinicians should consider SARS-CoV-2 as a potential trigger for unexplained neuropathic pain, even in the absence of typical respiratory symptoms.