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J Hand Microsurg
DOI: 10.1055/s-0043-1764161
Case Report

Ultramicronized Palmitoylethanolamide and Luteolin: Drug Candidates in Post-COVID-19 Critical Illness Neuropathy and Positioning-Related Peripheral Nerve Injury of the Upper Extremity

Luca Roncati 
1   Department of Surgery, Medicine, Dentistry, and Morphological Sciences with interest in Transplantation, Oncology and Regenerative Medicine, Institute of Pathology, University of Modena and Reggio Emilia, Polyclinic Hospital, Modena, Italy
,
Caterina Marra
2   Department of General Surgery and Surgical Specialties, Unit of Plastic and Reconstructive Surgery, University Hospital of Modena, Modena, Italy
,
Davide Gravina
3   Department of Musculoskeletal System, Unit of Orthopedics and Traumatology, University Hospital of Modena, Modena, Italy
,
Gianluca Di Massa
1   Department of Surgery, Medicine, Dentistry, and Morphological Sciences with interest in Transplantation, Oncology and Regenerative Medicine, Institute of Pathology, University of Modena and Reggio Emilia, Polyclinic Hospital, Modena, Italy
,
Norman Della Rosa
4   Department of Musculoskeletal System, Unit of Hand Surgery and Microsurgery, University Hospital of Modena, Modena, Italy
,
Roberto Adani
4   Department of Musculoskeletal System, Unit of Hand Surgery and Microsurgery, University Hospital of Modena, Modena, Italy
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Abstract

Coronavirus disease 2019 (COVID-19) is the most dramatic pandemic of the new millennium and patients with serious infection can stay in intensive care unit (ICU) for weeks in a clinical scenario of systemic inflammatory response syndrome, likely related to the subsequent development of critical illness polyneuropathy (CIP). It is in fact now accepted that COVID-19 ICU surviving patients can develop CIP; moreover, prone positioning-related stretch may favor the onset of positioning-related peripheral nerve injuries (PNI). Therefore, the urgent need to test drug candidates for the treatment of these debilitating sequelae is emerged even more. For the first time in medical literature, we have successfully treated after informed consent a 71-year-old Italian man suffering from post-COVID-19 CIP burdened with positioning-related PNI of the left upper extremity by means of ultramicronized palmitoylethanolamide 400 mg plus ultramicronized luteolin 40 mg (Glìalia), two tablets a day 12 hours apart for 6 months. In the wake of our pilot study, a larger clinical trial to definitively ascertain the advantages of this neuroprotective, neurotrophic, and anti-inflammatory therapy is advocated.

Keywords

coronavirus disease 2019 - critical illness polyneuropathy - positioning-related peripheral nerve injury - palmitoylethanolamide - luteolin

Authors' Contributions

LA and RA were involved in conceptualization and investigation. DG and GDM helped in bibliographic resources. LR and CM contributed to data curation and writing—original draft preparation. NDR and RA supervised the study. All authors have read and agreed to the published version of the manuscript.


Ethical Approval

The study was conducted in accordance with the ethical standards and the Declaration of Helsinki of 1975, as revised in 2008.


Informed Consent

Informed consent was obtained from the subject involved in the study; sensitive data and images have been entirely anonymized.


Data Availability

The data presented in this study are available on request from the corresponding author.




Publication History

Article published online:
13 March 2023

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