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. 2022 Oct 28;5(6):e887.
doi: 10.1002/hsr2.887. eCollection 2022 Nov.

Facial palsy as a manifestation of COVID-19: A systematic review of cases

Aiman Khurshid  1 , Maman Khurshid  2 , Aruba Sohail  2 , Imran Mansoor Raza  2 , Muhammad Khubab Ahsan  3 , Mir Umer Farooq Alam Shah  4 , Anab Rehan Taseer  5 , Abdulqadir J Nashwan  6 , Irfan Ullah  7
Affiliations

Facial palsy as a manifestation of COVID-19: A systematic review of cases

Aiman Khurshid et al. Health Sci Rep. .

Abstract

Background and aims: Facial palsy is a rare complication of the COVID-19 infection. Herein, we conducted a systematic review of all published cases of facial palsy post-COVID-19 infection in an attempt to educate the general population and medical practitioners regarding the likely occurrence of facial palsy in COVID-19 patients, its detection, effective treatment plan, and prognosis of the condition.

Methods: We searched PubMed, Google Scholar, and Directory of Open Access Journals (DOAJ) from December 1, 2019 to September 21, 2021.

Results: We included 49 studies bearing accounts of 75 cases who had facial palsy. The mean age of patients was 42.9 ± 19.59 years, with a male-to-female ratio of 8:7. The majority of the cases were reported from Brazil (n = 14), USA (n = 9), Turkey (n = 9), and Spain (n = 9). Noticeably, 30.14% of COVID-19 patients were diagnosed with Guillain-Barré syndrome. In total, 22.97% of patients complained of bilateral facial paralysis (n = 17), whereas ipsilateral paralysis was observed in 77.03% (n = 57). These were common complaints of Lagophthalmos, otalgia, facial drooping, dysarthria, and compromised forehead wrinkling. The treatment regimen mainly included the use of corticosteroids (n = 51) (69.86%), antivirals (n = 23) (31.51%), IVIG (n = 18) (24.66%), antibiotics (n = 13) (17.81%), antiretroviral (n = 9) (12.33%), and antimalarial (n = 8) (10.96%) medications. In all, 35.62% of patients (n = 26) adhered to a combination of antiviral and corticosteroid-based therapy. Positive treatment outcomes were observed in 83.58% (n = 56) of cases. In contrast, 10 patients (14.93%) showed nonsignificant recovery, out of which 3 (4.48%) died from the disease.

Conclusion: The association of facial palsy with COVID-19 is controversial and therefore requires further investigation and published work to confirm a causal relationship. However, physicians should not overlook the likelihood of facial palsy post-COVID-19 infection and treat it accordingly.

Keywords: COVID‐19; SARS‐CoV‐2; facial palsy; neurological symptoms; systematic review.

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Conflict of interest statement

Abdulqadir J. Nashwan is an Editorial Board member of Health Science Reports and co‐author of this article. He is excluded from editorial decision‐making related to the acceptance of this article for publication in the journal. The remaining authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of selected studies
Figure 2
Figure 2
Pathophysiology behind the onset of facial palsy in COVID‐19 patients
See this image and copyright information in PMC

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