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Many patients report persistent symptoms attributable to dysfunction of the peripheral nervous and muscular systems after acute COVID-19. These symptoms may constitute part of the so-called post–acute COVID-19 syndrome (PACS), or may result from neuromuscular complications of hospitalisation in intensive care units (ICUs). This article provides an updated review of symptoms of potential neuromuscular origin in patients with PACS, differentiating symptoms according to muscle, peripheral nerve, or autonomic nervous system involvement, and analyses the forms of neuromuscular involvement in patients who were admitted to the ICU due to severe COVID-19. Resumen: Los pacientes que han padecido COVID-19 frecuentemente refieren síntomas persistentes atribuibles a disfunción del sistema nervioso periférico y muscular. Estos síntomas pueden formar parte del denominado síndrome COVID-19 post-agudo (post-acute COVID-19 syndrome o PACS) o pueden surgir como consecuencia de las complicaciones neuromusculares del ingreso en unidades de cuidados intensivos (UCI). En este manuscrito se realiza una revisión actualizada de los síntomas de potencial origen neuromuscular en pacientes afectos de PACS, diferenciándolos en función de su posible origen a nivel de músculo, nervio periférico o sistema nervioso autónomo, así como las formas de afectación neuromuscular en pacientes que precisaron ingreso en UCI por COVID-19 grave.

Introduction: Available studies provide limited guidance on the use of neuroimaging in patients with headache in the outpatient setting. The aim of this study was to describe and analyse the frequency and the percentage of neuroimaging abnormalities in patients evaluated for headache in a neurology clinic, as well as to determine which red flags are most commonly associated with these abnormalities., Patients and Methods: We conducted an observational, descriptive and cross-sectional study of a series of patients with headache from the neurology department of the Hospital Universitario de Mostoles who underwent a neuroimaging test., Results: A total of 279 patients (190 women and 89 men) were included in the study. No patient without any red flags had severe abnormalities in the neuroimaging study and, of those with red flags (219 patients), only 2.3% (five patients) displayed severe abnormalities. The two red flags that were significantly associated with an increased likelihood of severe neuroimaging abnormalities were headache that is triggered or significantly worsened by postural changes or Valsalva manoeuvres and chronic daily headache since onset., Conclusions: The prevalence of significant neuroimaging abnormalities in headache patients in an outpatient setting was low, even in the presence of red flags, and so their utility appears to be lower in an outpatient setting. It may be reasonable to try to reduce the use of neuroimaging with headache patients in the outpatient setting.

Many patients report persistent symptoms attributable to dysfunction of the peripheral nervous and muscular systems after acute COVID-19. These symptoms may constitute part of the so-called post-acute COVID-19 syndrome (PACS), or may result from neuromuscular complications of hospitalisation in intensive care units (ICUs). This article provides an updated review of symptoms of potential neuromuscular origin in patients with PACS, differentiating symptoms according to muscle, peripheral nerve, or autonomic nervous system involvement, and analyses the forms of neuromuscular involvement in patients who were admitted to the ICU due to severe COVID-19., (© 2021 Sociedad Española de Neurología. Published by Elsevier España, S.L.U.)