Late peripheral facial paralysis after COVID-19: a rapid systematic review and two case reports

Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a sys...

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Published in:	The journal of venomous animals and toxins including tropical diseases Vol. 28; p. e20220020
Main Authors:	Cavalcante, Thalitta Mendes, Gubert, Vanessa Terezinha, Lima, Carolina de Deus, Luciano, Larissa Anjos, Croda, Mariana Garcia, Venturini, James, Gasparoto, Antonio Luiz Dal Bello, Santiago, Wellyngton Matheus Souza, Motta-Castro, Ana Rita Coimbra, Reis, Fernanda Paes, Marques, Ana Paula da Costa, Lorenz, Aline Pedroso, Fava, Wellington Santos, Zardin, Marina Castilhos Souza Umaki, Chaves, Cláudia Elizabeth Volpe, Braga, Gabriel Pereira, Paniago, Anamaria Mello Miranda, Oliveira, Sandra Maria do Valle Leone de
Format:	Journal Article
Language:	English
Published:	Centro de Estudos de Venenos e Animais Peçonhentos (CEVAP/UNESP) 2022 SciELO
Subjects:	Neurological manifestation Peripheral facial paralysis Post-COVID Review SARS-CoV-2 infection TOXICOLOGY TROPICAL MEDICINE Post-COVID SARS-CoV-2 infection Neurological manifestation Peripheral facial paralysis
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Summary:	Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 Authors’ contributions: TMC, AMMP and SMVLO contributed to the conception and design of the work. TMC, CDL, LAL, ALDBG, VTG, WMSS, APCM contributed to the acquisition of systematic review data for the work. JV, ARCM-C, FPR, APL, WSF and MCSUZ contributed to the laboratory analysis for the work. TMC, MGC, CEVC and GPB contributed to the interpretation of data for the work. All authors contributed to drafting the work or revising it critically for important intellectual content; read and approved the final manuscript; and ensured that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Competing interests: The authors declare that they have no competing interests.
ISSN:	1678-9199 1678-9199
DOI:	10.1590/1678-9199-jvatitd-2022-0020