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

• Published in: Journal of Venomous Animals and Toxins including Tropical Diseases
• Main Authors: Thalitta Mendes Cavalcante, Vanessa Terezinha Gubert, Carolina de Deus Lima, Larissa Anjos Luciano, Mariana Garcia Croda, James Venturini, Antonio Luiz Dal Bello Gasparoto, Wellyngton Matheus Souza Santiago, Ana Rita Coimbra Motta-Castro, Fernanda Paes Reis, Ana Paula da Costa Marques, Aline Pedroso Lorenz, Wellington Santos Fava, Marina Castilhos Souza Umaki Zardin, Cláudia Elizabeth Volpe Chaves, Gabriel Pereira Braga, Anamaria Mello Miranda Paniago, Sandra Maria do Valle Leone de Oliveira
• Format: Article in Journal/Newspaper
• Language: English
• Published: SciELO 2022
• Subjects: SARS-CoV-2 infection; Peripheral facial paralysis; Post-COVID; Neurological manifestation; Arctic medicine. Tropical medicine; RC955-962; Toxicology. Poisons; RA1190-1270; Zoology; QL1-991; Arctic
• Online Access: https://doi.org/10.1590/1678-9199-jvatitd-2022-0020; https://doaj.org/article/0cae8538985d4375997fe99e3ff8fd31

Abstract 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.