Facial paralysis as the only symptom of COVID-19: A prospective study

• Published in: American journal of otolaryngology 2021-07, Vol.42 (4), p.102956-102956, Article 102956
• Main Authors: Islamoglu, Yuce, Celik, Burak, Kiris, Muzaffer
• Format: Article
• Language: English
• Subjects: Adult; Antibodies; Asymptomatic; Bell's palsy; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - diagnosis; COVID-19 - therapy; Cross-Sectional Studies; Disease; Electronic government; Ethics; Etiology; Facial paralysis; Facial Paralysis - virology; Female; Guillain-Barre syndrome; Humans; IgG antibody; Immunoglobulin G; Immunoglobulin G - blood; Immunoglobulin M; Immunoglobulin M - blood; Inflammation; Ischemia; Laboratories; Magnetic resonance imaging; Male; Middle Aged; Nervous system; Otolaryngology; Pandemics; Paralysis; Paresis; Pathogenesis; Patients; Prospective Studies; SARS-CoV-2; SARS-CoV-2 - immunology; SARS-CoV-2 - isolation & purification; SARS-CoV-2 IgG + IgM; Serology; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Symptom Assessment; Viral infections; Viruses
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2021.102956

Idiopathic facial palsy is called as Bell's palsy and reports showed that facial paralysis increased during COVID-19 pandemic period. There are many reports about the relationship between COVID-19 and facial paralysis but there is no prospective study. SARS-CoV-2 IgG and IgM antibodies increase in COVID-19. Our purpose is to investigate SARS-CoV-2 IgG + IgM antibody in the Bell's palsy. Prospective cross-sectional study was planned. Patients with acute peripheral facial paralysis with no reason and diagnosed as Bell's palsy was included in the study. In order to investigate SARS-CoV-2 in the etiologies of these patients, SARS-CoV-2 IgM + IgG (total) test was studied. SARS-CoV-2 IgG + IgM was measured by using the ADVIA Centaur® test kit. Test reports result in index values and as nonreactive or reactive. The results were analyzed. Forty-one patients were included in the study. The average age of the patients was 41,7. 17 (41,4%) were female and 24 (58,6%) were male. 21 patients had left-sided; 20 had right-sided paralysis. SARS-CoV-2 IgG + IgM values were measured two times of the patients. First control was in the first week of facial paralysis, 10 (24,3%) positivity was found. The average index of the positive patients were 6,74 (min.1,39–max.10) in the first control and 9,585 in the second control (min.8,7–max. 10). We found that the SARS-CoV-2 IgM + IgG antibody test was positive in 24.3% of the patients with Bell's palsy. The results are higher than the seroprevalence studies conducted in asymptomatic individuals. Facial paralysis could be the only symptom of COVID-19 but further studies must be done.