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Q. Why is there numbness and weakness in the legs, face, and arms of a patient with COVID-19?

Answered by
Dr. Hitesh Kumar
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Dec 15, 2021

Hi doctor,

I have COVID-19, and I am in the last few days of isolation. My legs, face, and now arms have started to get weak and numb throughout isolation. The numbness and weakness progressed quite slowly at first but have sped up quite quickly. I feel like my heart rate spikes as well. I have been prescribed Prednisone for COVID-19 and Cefalexin for a UTI (urinary tract infection).

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Hello,

Welcome to icliniq.com.

I would like to know some details about your symptoms:

a. When were you detected to have COVID-19, and how many days before?

b. Since how many days, you started to have numbness and weakness in your legs?

c. Since how many days, you started to have numbness and weakness in your arm?

d. How much is the intensity of leg and arm weakness:

i) Are you able to stand and walk without any support?

ii) Are you able to stand up from a squatting position?

iii) Are you able to hold objects firmly in your hand grip?

iv) Are you able to raise your arms above the shoulder without difficulty?

e. What exactly happens in numbness in legs and arms?

i) Do you feel tingling or burning sensations in your arms and legs?

ii) Do you have diminished sensation in arms and legs?

f. Did you had you any neck or back pain?

g. Did you had any difficulty in holding urine or control of urine?

h. Do you have any breathing difficulty during COVID-19 and required oxygen therapy?

i. Do you have pain in some other body sites such as thigh, arm, or forearm?

Other information:

i. How is your sleep routine? - Do you get sleepy soon after lying in bed or does it take a long time? - Once got sleepy, do you have frequent awakenings during sleep? Do you feel fresh on awakening from sleep in the morning?

ii. How is your usual mood in day-to-day activities? Happy or toward the sad side (thinking about past events) or toward the worried side (thinking about future things, irritable or something else)?

iii. How is your appetite?


Investigations to be done:

CBC (complete blood count).
LFT (liver function test).
KFT (kidney function test).
CPK Total (Creatine phosphokinase).
CRP (C-Reactive Protein).
NCV (nerve conduction velocity) tests all four limbs.
MRI (magnetic resonance imaging) whole spine
Serum Calcium.
Serum Vitamin B12.
Serum Vitamin D3.

Regarding follow up:

Revert with the above-mentioned information for better understanding and further judgment.

Hi doctor,

Thank you for your reply.

Sorry I did not reply sooner, as I never set my notifications up correctly. I went through numbness and weakness this month. Due to the numbness in my left leg and face getting worse over a few days, I got checked for a stroke and other things like tingling and burning sensation and then got sent home. I did a PCR test for COVID-19 10 days back, and that was positive. In the meantime, the numbness would seem to progress in different parts of my body but also, some days, not progress at all. A week back, I was prescribed 30 mg Prednisolone for COVID-19 and potential Gillian barre syndrome and got prescribed 500 mg Cefalexin for potential UTI by my general practitioner because even if I go to the toilet, I get the feeling like I still had to go. Through this process, my numbness and weakness are progressing sporadically. Sometimes it seems fast, and then sometimes it is not progressing at all.

I can still walk and move my hands and lift them above my head, but when I have weakness, it seems harder to hold things firmly and stand up from a seated position. Over the last few days, my arm weakness episodes seem to be getting worse and more frequent. I have been speaking to a doctor and reading the internet. The doctor thought I might be experiencing Gillian barre syndrome or some form of cytokines storm, but he said I would not get treatment because I am still in isolation for COVID-19. I did not have bad COVID-19 symptoms, really just a bit of a fever, a little bit of shortness of breath, and bits of pain. I barely got a cough, but I do randomly get heart rate spikes. I have been using an oximeter that has not shown anything abnormal apart from the increased heart rate occasionally. I feel a tingling and burning sensation in my arms and legs, but it is not painful. When it happens, it does affect my sleep. I will wake up multiple times. Sometimes I go to sleep very quickly, and sometimes the tingling and weakness affect sleeping, and I will wake multiple times but still be able to fall asleep quite quickly. I can still pass urine, but I do not notice when my bladder is full that sensation seems diminished, but I can still go. My mood throughout this whole thing has not been good, and my father got COVID-19 at the same time, so I have been worrying about him too. I have been eating less during this whole thing. Sorry about my bad grammar. I am on the phone.

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Hello,

Welcome back to icliniq.com.

By your descriptions, it is very difficult to make a final conclusion about your symptoms. Coronavirus is a new virus and till now it has been found to involve other organs including muscles, nerves. brain, or spinal cord. By your tele consultation description, it is not clear which organ is affected. It needs to be examined physically. Also by your description, you told that you are very anxious. Sometimes severe anxiety can also lead to such symptoms. But few possibilities come in my mind, which need to be looked for or to be ruled out:

1. Guillain Barre Syndrome.

2. Myelitis (inflammation of the spinal cord).

3. Myositis (Inflammation of the muscles) or Myalgia (muscle pain).

4. Severe anxiety with panic attacks. My suggestion will be to consult doctor physically (instead of tele consultation), so that detailed physical examination can be done and followed by relevant investigations to affirm or rule out the possibilities.


Investigations to be done:

NCV for all four limbs.
MRI whole spine with contrast.
CPK - total.
CBC, LFT, KFT.
Electrolytes.
Blood sugar - fasting.
T3 (Triiodothyronine), T4 (thyroxine), and TSH (thyroid-stimulating hormone).
CRP.
Serum Calcium.
Serum Vitamin B12.
Serum Vitamin D3.

Regarding follow up:

Suggest to consult doctor physically for detailed assessment and further management.


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