Advanced imaging helps diagnose post-COVID-19 nerve, muscle injuries: study

By Xu Jing

CHICAGO, Dec. 1 (Xinhua) -- A Northwestern Medicine study shows how advanced imaging technology can pinpoint what may have caused COVID-19 patients' nerve damage and help determine the best course of treatment.

Previous research from Northwestern (NU) found COVID-19 patients can experience nerve damage after being flipped onto their stomachs in the ICU as a life-saving measure to help them breathe. The new study demonstrates how advanced imaging aids this cohort of patients as well as two additional patient cohorts with COVID-19-related nerve damage.

All patients in the study had tested positive for COVID-19.

The imaging described in the study includes ultra-high-resolution ultrasound and MR neurography, MRI of peripheral nerves which impact the arms and legs. They can help localize where a patient's problem is, show the severity of nerve damage, how many nerves are affected and if the nerve damage also has impacted the muscles.

If imaging technology discovers nerve damage caused by stretch injury because of prone positioning, the patient may be referred to a physician who specializes in rehabilitation or peripheral nerve surgery. If imaging finds nerve damage due to an inflammatory response, the patient may be better served by seeing a neurologist. If imaging reveals nerve damage from a hematoma, blood thinner medications would have to be adjusted immediately and the patient may even have to see a surgeon.

For COVID-19 patients and survivors with neuromuscular complications or "long-hauler" symptoms, imaging can help reveal the problem and guide further treatment.

The advanced ultrasound technology is new, portable, less expensive and can sometimes be even better at detecting nerve damage than MRI, said lead author Swati Deshmukh, assistant professor of radiology at NU Feinberg School of Medicine and a Northwestern Medicine radiologist. Ultrasound also can be performed on patients who are unable to tolerate MR imaging.

The study, the first of its kind in summarizing how these advanced imaging techniques can help physicians identify and treat nerve damage in COVID-19 patients, is published Tuesday in the journal Radiology.

Northwestern Medicine is the collaboration between Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine, which includes research, teaching and patient care.

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