A 26-year-old male patient was admitted with symptoms of cough and fever for three
days. Chest computed tomography showed multiple and bilateral ground-glass opacities,
predominantly peripheral, some with superimposed intralobular septal thickening ([Figure 1]). Nasopharyngeal swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
on real-time reverse-transcription-polymerase-chain reaction (RT-PCR) assay was positive.
On the eighth day of illness, he developed right facial weakness consistent with facial
nerve palsy. Magnetic resonance imaging of the brain showed enhancement of the right
facial nerve ([Figure 2]).
Figure 1 Chest computed tomography showing multiple and bilateral ground-glass opacities,
predominantly peripheral (A and B), some with superimposed intralobular septal thickening
(B) (white arrows).
Figure 2 Contrast enhanced magnetic resonance of the skull showing enhancement of the right
facial nerve (white arrows), in the axial (A) and coronal (B) planes.
Neurological manifestations of coronavirus disease 2019 (COVID-19) have been associated
with immune-mediated injuries rather than direct viral neurotropism, occurring in
about 36% of patients, including strokes, vasculitis and Guillain-Barré[1],[2],[3]. We emphasize that it is paramount to be aware of the possibility of facial paralysis
in these patients.
