Small-Fiber Neuropathy Possibly Associated with COVID-19

COVID-19 has caused several neurological complications by affecting the central and peripheral nervous systems (PNS). Studies on the PNS involvement in COVID-19 are limited. These complications are likely unreported, given the difficulty of obtaining further diagnostic information, such as expert neurologist evaluation, electrodiagnostic testing, and skin biopsy. Herein, we report 2 cases of possible COVID-19-related small-fiber neuropathy (SFN). These cases are reported to increase awareness of a possible link between COVID-19 and SFN. Additional investigation, including neurology consultation, nerve conduction studies, and skin biopsy, should be considered in patients who develop paresthesia during and after COVID-19 infection. Further research is also needed to determine a possible underlying neuropathology mechanism and the role of immunomodulatory treatment, such as intravenous immunoglobulin, in COVID-19-related SFN.