Internal Tremors and Vibration Symptoms Among People with Post-Acute Sequelae of SARS-CoV-2: A narrative review of patient reports

  1. Daisy Massey
  2. Anna D Baker
  3. Diana Zicklin Berrent
  4. Nick Güthe
  5. Suzanne Pincus Shidlovsky
  6. Liza Fisher
  7. Connor B Grady
  8. César Caraballo
  9. Richa Sharma
  10. Harlan M Krumholz

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Abstract

To introduce the perspective of patients who have PASC with vibrations and tremors as a prominent component, we leveraged the efforts by Survivor Corps , a grassroots COVID-19 patient advocacy group, to gather information from people in their Facebook group suffering from vibrations and tremors. Survivor Corps collected 140 emails and 450 Facebook comments from members. From the emails, we identified 22 themes and 7 broader domains based on common coding techniques for qualitative data and the constant comparative method of qualitative data analysis. Facebook comments were analyzed using Word Clouds to visualize frequency of terms. The respondents’ emails reflected 7 domains that formed the basis of characterizing their experience with vibrations and tremors. These domains were: (1) symptom experience, description, and anatomic location; (2) initial symptom onset; (3) symptom timing; (4) symptom triggers or alleviators; (5) change from baseline health status; (6) experience with medical establishment; and (7) impact on people’s lives and livelihood. There were 22 themes total, each corresponding to one of the broader domains. The Facebook comments Word Cloud revealed that the 10 most common words used in comments were: tremors (64), covid (55), pain (51), vibrations (43), months (36), burning (29), feet (24), hands (22), legs (21), back (20). Overall, these patient narratives described intense suffering, and there is still no diagnosis or treatment available.

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    SciScore for 10.1101/2021.12.03.21267146: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Nick Güthe spoke with Survivor Corps, who initiated a call for people in their Facebook group of ∼180,000 to report their experience with vibrations and tremors among those with PASC (posts can be found in Supplement 1).
    PASC
    suggested: (PASC , RRID:SCR_016642)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has limitations. The data included in this report are self-reported from people in response to a query. The information was limited to what people provided and there was no follow-up to obtain more information. The study presents what people shared on their initial communication. Also, some people did not have formal testing for infection. Any information about testing is based on self-report. In addition, there was little demographic information available for analysis. Also, because this is a convenience sample of people responding to the queries, this study cannot provide information on the incidence and prevalence of these symptoms. In conclusion, some people report experiencing internal vibration and tremor symptoms, often causing intense suffering, after a self-reported history of SARS-CoV-2 infection. The symptoms had some common features but there was variability in timing, concomitant symptoms, and impact. Further research is needed to understand and alleviate this suffering, by studying the extent and scope of these symptoms, possible mechanisms, and potential treatment.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.12.03.21267146 on medRxiv