COVID-19 and upper limb compression neuropathies: a review

Background and aim: COVID-19 may be asymptomatic or have a typical presentation with fever, cough, anosmia, lymphocytopenia. In some cases, it occurs with a “chimeric” presentation, with more subtle and ambiguous symptoms which may be initially misdiagnosed and are referred to in long covid conditions. A possible central and peripheral nervous system involvement has been recognized. We review the literature about the association between upper limb compressive neuropathies and SARS-CoV-2 infection. The purpose of this paper is to try to demonstrate a correlation between SARS-CoV-2 infection and canalicular syndromes of the upper limb. Although the respiratory manifestations of COVID-19 have been widely studied, there is emerging evidence suggesting potential associations between COVID-19 and various other health conditions. Methods: During November and October 2023, we carried out a systematic review to identify all scientific publications discussing the relationship between COVID-19 infection and compressive neuropathies of the upper limb. We followed PRISMA guidelines and searched in the PubMed database. We selected 24 articles. After a screening process, we keep 6 articles complying with inclusion criteria. Results: We found 24 patients who had developed canaliculopathies of the upper limb after COVID-19. The papers examined in this review did not hypothesize a clear pathological pathway, but rather examined a multifactorial one. Both SARS-CoV-2 infection and vaccination have been reported as possible causes of compression neuropathies. Conclusions: Nowadays, the world literature is not clear regarding the etiology of the association between upper limb compressive neuropathies and COVID-19. We conclude a causal relation may exist and needs to be further investigated.