Çiğdem FIRAT KOCA, Turgut ÇELİK, Mehmet KELLEŞ, Şükrü AYDIN, Şeyma YAŞAR

Peripheral facial paralysis during the COVID-19 pandemic

The mechanism surrounding idiopathic peripheral facial nerve paralysis remains unclear, though viral infections and even immunizations have been suspected of its origin. Thus, the relationship between COVID-19 and facial paralysis should be studied. With this research, we aimed to investigate the characteristics of facial paralysis during the COVID-19 illness as well as the relationship between facial paralysis and COVID-19, the length of time needed for recovery, concurrence with COVID-19 infection, and whether facial paralysis is a late complication or initial symptom of the disease. Forty-five patients thought to have had idiopathic peripheral facial paralysis were included in the study. Pure tone audiometry, COVID-19 PCR tests, and contrast-enhanced ear MRIs were performed on all participants. A standard prednisolone treatment protocol was followed. Participants were monitored for one month; we recorded whether they had COVID-19 previously, initially, or contracted it within the one-month testing period. At the same time, facial paralysis recovery rates were recorded and used in statistical analyses. PCR test at initial admission was reported as positive for COVID-19 in only one participant (2.2%). We discovered an improvement delay regarding facial paralysis in participants who had had COVID-19 previously (p

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1. Banerjee S, Sarkar S, Bandyopadhyay SN. Survey and analysis of knowledge, attitude, and practice among otolaryngologists in a state in eastern India in relation to the coronavirus disease 2019 pandemic. J Laryngol Otol. 2020;134:696-702.
2. Zaim S, Chong JH, Sankaranarayanan V, et al. COVID-19 and multiorgan response. Curr Probl Cardiol. 2020;45:100618.
3. Desforges M, Le Coupanec A, Dubeau P, et al. Human coronaviruses and other respiratory viruses: underestimated opportunistic pathogens of the central nervous system? Viruses. 2019;12:14.
4. Hamming I, Timens W, Bulthuis ML, et al. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203:631-7.
5. Berger JR. COVID-19 and the nervous system. J Neurovirol. 2020;26:143- 8.
6. Mao L, Jin H, Wang M, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;77:683-90.
7. Giacomelli A, Pezzati L, Conti F, et al. Self-reported olfactory and taste disorders in patients with severe acute respiratory coronavirus 2 infection: a cross-sectional study. Clin Infect Dis. 2020;71:889-90.
8. Derollez C, Alberto T, Leroi I, et al. Facial nerve palsy: an atypical clinical manifestation of COVID-19 infection in a family cluster. Eur J Neurol. 2020;27:2670-2.
9. McCormick DP. Herpes-simplex virus as a cause of Bell's palsy. Lancet. 1972;1:937-9.
10. Peitersen E. Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl. 2002;549:4- 30.
11. Lewis DJ, Huo Z, Barnett S, et al. Transient facial nerve paralysis (Bell's palsy) following intranasal delivery of a genetically detoxified mutant of Escherichia coli heat labile toxin. PLoS One. 2009;4:e6999.
12. Costello F, Dalakas MC. Cranial neuropathies and COVID-19: neurotropism and autoimmunity. Neurology. 2020;95:195-6.
13. Natoli S, Oliveira V, Calabresi P, et al. Does SARS-CoV-2 invade the brain? Translational lessons from animal models. Eur J Neurol. 2020;27:1764-73.
14. Madhok VB, Gagyor I, Daly F, et al. Corticosteroids for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2016;7:Cd001942.
15. Caytemel B, Kilic H, Comoglu S. Approach to otolaryngology emergency in COVID-19 pandemic. Turkish J Ear Nose Throat. 2020;30:24-36.
16. Islamoglu Y, Celik B, Kiris M. Facial paralysis as the only symptom of COVID-19: A prospective study. Am J Otolaryngol. 2021;42:102956.
17. Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell’s palsy. Otolaryngol Head Neck Surg. 2013;149:S1-S27.
18. Zammit M, Markey A, Webb C. A rise in facial nerve palsies during the coronavirus disease 2019 pandemic. J Laryngol Otol. 2020;134:905-8.
19. Codeluppi L, Venturelli F, Rossi J, et al. Facial palsy during the COVID‐19 pandemic. Brain Behav. 2021;11:e01939.
20. Mutlu A, Kalcioglu MT, Gunduz AY, Bakici B, Yilmaz U, Cag Y. Does the SARS-CoV-2 pandemic really increase the frequency of peripheral facial palsy? Am J Otolaryngol. 2021;42:103032.
21. Acharya A, Kevadiya BD, Gendelman HE, et al. SARS-CoV-2 infection leads to neurological dysfunction. J Neuroimmune Pharmacol. 2020;15:167- 73.
22. Dubé M, Le Coupanec A, Wong AHM, et al. Axonal transport enables neuron-to-neuron propagation of human coronavirus OC43. J Virol. 2018;92:e00404–18.
23. Ahmad I, Rathore FA. Neurological manifestations and complications of COVID-19: A literature review. J Clin Neurosci. 2020;77:8-12.
24. Li Y, Fu L, Gonzales DM, et al. Coronavirus neurovirulence correlates with the ability of the virus to induce proinflammatory cytokine signals from astrocytes and microglia. J Virol. 2004;78:3398-406.