Complex regional pain syndrome after severe COVID-19 – A case report

Neurological complications are frequently reported in an intensive care unit (ICU), as a manifestation of a critical systemic illness or of its treatment. On the specific setting of COVID-19 patients, peripheral nerve lesions can have a multiplicity of causes, such as post-infectious neuropathy, positioning-related neuropathy or iatrogeny. An unusual but potentially disabling complication of any peripheral nerve lesion is Complex Regional Pain Syndrome (CRPS). Although there have been no mechanistic studies assessing how SARS-CoV-2 might directly impact nociception, it is hypothesized that the systemic hyperinflammation seen in severe COVID-19 may contribute to peripheral and central neuronal sensitization, possibly increasing the risk of developing CRPS. This case report highlights the potential hazards and consequences of peripheral nerve injuries on an ICU setting in COVID-19 patients, as well as the importance of a multidisciplinary approach for an early diagnosis and treatment, which are directly related to a better prognosis. •In an intensive care unit, neurological complications are frequently encountered.•CRPS may occur after peripheral nerve injuries, leading to increased disability.•The systemic hyperinflammation of severe COVID-19 may contribute to neuronal sensitization.•Peripheral and central neuronal sensitization can lead to chronical and disproportionate pain.•A multidisciplinary approach is important in prompt diagnosis and treatment. COVID-19; Critical care; Complex regional pain syndrome; Peripheral nerve injury; Case report.