Study: 59% of long-COVID patients had nerve damage
A retrospective study of 17 COVID-19 survivors with lingering symptoms reveals that 10 (59%) had nerve damage, which the researchers said could have been triggered by potentially treatable infection-related immune dysfunction.
In the study, published yesterday in Neurology: Neuroimmunology & Neuroinflammation, Massachusetts General Hospital (MGH) researchers analyzed data from long COVID patients with no history of neuropathy or risks of neuropathy who were referred for evaluation of peripheral neuropathy, meaning nerve damage not involving the brain or spinal cord.
Patients were from 10 states and territories, and all but one had mild infections. The study period was Feb 21, 2020, to Jan 19, 2021, and participants were tracked for, on average, 1.4 years. Average participant age was 43.3 years, 69% were female, 94% were White, and 19% were Latino.
Ten had at least one test confirming neuropathy, including 63% of skin biopsies, 17% of electrodiagnostic tests, and 50% of autonomic function tests. The critically ill patient was diagnosed as having axonal neuropathy, while another had multifocal demyelinating neuropathy 3 weeks after mild illness, and more than 10 had small-fiber neuropathy (SFN).
Common neuropathy symptoms were weakness, sensory changes, and pain in the hands and feet, and many patients reported fatigue.
Thirty-five percent of patients were given corticosteroids or intravenous immune globulins. The five patients who received immunoglobulin G appeared to derive a benefit. Over time, 52% of participants improved, but none experienced total resolution.
"This report strengthens evidence linking several idiopathic multisymptom conditions—including SFN and fibromyalgia—with dysimmunity, sometimes incident to infections or vaccinations," the study authors wrote.
While rigorous clinical trials evaluating specific post-COVID neuropathy treatments haven't been conducted, lead author Mary Louise Oaklander, MD, PhD, said in an MGH press release that COVID survivors with lingering nerve-related symptoms might want to see their primary care physician, neurologist, or neuromuscular specialist.
"Research from our team and others is clarifying what the different types of post-COVID neuropathy are, and how best to diagnose and treat them," she said. "Some patients seem to improve from standard treatments for other immune-related neuropathies."
Mar 1 Neurol Neuroimmunol Neuroinflamm study
Mar 1 MGH press release
High-path avian flu spreads to flocks in Connecticut and Iowa
Highly pathogenic avian flu outbreaks have been detected in backyard flocks in two more states, Connecticut and Iowa, the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) said today. The new detections put the number of states reporting the virus in poultry or other captive bird settings to nine.
So far, it's not clear where the Connecticut outbreak occurred. However, recent waterfowl sampling has turned up H5 or H5N1 30 times across three Connecticut counties: New Haven, New London, and Middlesex.
Iowa's outbreak involved a backyard poultry flock in Pottawattamie County, which is in the southwestern part of the state on the border with Nebraska, the Iowa Department of Agriculture and Land Stewardship (IDALS) said today. Unlike Connecticut, there haven't been any recent waterfowl detections in Iowa.
In related developments, the Indiana Board of Animal Health (IBAH) in an email update yesterday reported another outbreak at a turkey farm, the state's sixth. The outbreak occurred at a farm in Dubois County, the third in the county, and struck a facility housing 16,500 birds, which are slated for culling. So far, the outbreaks have led to the loss of 171,281 turkeys.
The new outbreaks are part of activity involving the Eurasian H5N1 strain, which has also led to poultry losses in multiple world regions.
Mar 2 APHIS statement
Mar 2 IDALS statement
APHIS wild bird detection page
In international developments, late last week India reported a new highly pathogenic H5N1 event, which involves three outbreaks at poultry farms in Maharashtra state, according to a notification from the World Organisation for Animal Health (OIE).
The outbreaks began from Feb 2 to Feb 10, and, taken together, the virus killed 1,376 of 28,308 susceptible birds.
Feb 25 OIE report on H5N1 in India
NSABB takes on new review of risky pathogen experiments
The National Science Advisory Board for Biosecurity (NSABB), which advises the National Institutes of Health (NIH) on biosecurity and dual-use research issues, met 2 days ago for the first time since 2020 and took on new tasks.
The NIH has asked the NSABB to review government policies for experiments involving potentially dangerous pathogens. The goal is to help ensure that the policies allow the benefits of the research while managing potential risks, according to the Washington Post, which said the new review will also help define which research should and shouldn't take place.
The expert panel will examine both gain-of-function (GOF) research and dual-use research of concern (DURC). In January 2020, the NIH asked the NSABB to start reviewing the policies, but officials postponed the effort because of the pandemic.
According to meeting background materials, the group established one of two working groups, which will hold public listening sessions up until June. A stakeholder meeting is slated to take place sometime after August, with a draft report due for the NSABB to consider in December.
In 2012, the NSABB was instrumental in making recommendations regarding the publication of controversial H5N1 avian flu transmission studies involving DURC, and in 2016, the White House tapped the group to come up with guidance on assessing and funding GOF studies.
Mar 1 Washington Post report
NSABB meeting slides