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Ask The Expert, Part 2: Peripheral Neuropathy and COVID-19

Following our latest Ask the Expert session, the Foundation for Peripheral Neuropathy‘s Executive Director, Lindsay Colbert, asked its Scientific Advisory Board Chairman, Dr. Ahmet Höke MD, PhD, additional questions which came directly from the Foundation’s patients.

We are continually learning about COVID-19 and its impact on peripheral neuropathy patients. We hope that you find the below information helpful during these unprecedented times:

FPN: For patients who have an autoimmune form of PN and/or those who are currently undergoing IVIG treatments, are there any specific complications or concerns that should be noted with COVID-19?

Dr. Höke: Currently, we are not aware of specific complications related to COVID-19 and Intravenous Immunoglobulin (IVIG) treatments. However, given the recent news about some patients without significant risk factors developing strokes due to a hypercoagulable state, it is possible that IVIG may increase this risk. This is hypothetical at this stage, and any patients who are on IVIG should consult their doctors if they experience any symptoms of COVID-19.

FPN: Are patients who have chemo-induced peripheral neuropathy (CIPN), and thus a history of cancer, not considered at greater risk for COVID-19?

Dr. Höke: So far, the data suggests that a past history of cancer, by itself, does not seem to be a specific risk factor. However, having an active diagnosis of cancer and being immunocompromised due to cancer is a risk factor for more severe forms of COVID-19. Please see this link from the American Cancer Society.

FPN: Will the inflammations from COVID-19, specifically COVID toes, cause potential peripheral nerve damage for those who already have PN? What about those who do not have a history of neuropathy and have COVID toes – will these symptoms linger and turn into PN?

Dr. Höke: At this stage, it is difficult to answer these questions because we know so little about recent reports of how toes are being affected from COVID-19. If the findings are primarily due to vascular changes and the patient recover, it is highly unlikely that there will be long-term consequences.

FPN: Upon contracting COVID-19, some patients have experienced an increase in their PN-related symptoms. Is there any evidence to suggest why symptoms would heighten?

Dr. Höke: This is not unexpected. Many PN patients report similar “flare-ups” of their symptoms with influenza or other types of viral infections. This is likely to be due to heightened sensitivity of the sensory nerve fibers rather than an indication that there is actual, ongoing new damage to the nerve cells. However, we still do not know if the COVID-19 virus can infect the nerve cells or not. Our assessment of this may change in the future.


On behalf of the Foundation, thank you, Dr. Höke, for your time and expertise!


***Please note that these answers are not a replacement for proper medical advice. Additionally, the above answers may change as we learn more about this illness and how it affects the nervous system.


Thank you to those of you who submitted additional questions in recent weeks!

Have other questions that weren’t answered here?

Contact us at [email protected] and we will try our best to get those answers to you. Stay safe!

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