srjcmsSRJCMSSRJCMS2788-8851https://doi.org/10.47310/srjcms.2022.v02i01.023The Peripheral Nervous System Is a Common Target of SARS-Cov-2 InfectionsJosefFinstererDanielMatovuWe read with interest the review article by Taga and Lauria on the involvement of the peripheral nervous system (PNS) in SARS-CoV-2 infections [1]. In the period from January 1, 2020 to December 31, 2021 the authors identified 92 patients with Guillain-Barre syndrome (GBS), 37 patients with isolated cranial nerve neuropathies, and 18 patients with myositis [1]. Additionally, single patients with chronic inflammatory demyelinating polyneuropathy (CIDP), vasculitic neuropathy, neuralgic amyotrophy, critical care-related complications, and myasthenia gravis had been identified [1]. It was concluded that conclusions about a pathophysiological correlation between COVID-19 and PNS disorders remain premature and solely supported by their temporal association [1], that PNS complications after COVID-19 vaccines are limited to a possibly higher risk of facial nerve palsy and GBS, and that the widespread access to the ongoing vaccination campaign should not be discouraged [1]. The study is attractive but raises concerns that need to be discussed.  We disagree with the finding that only 92 patients with SARS-CoV-2 associated GBS were reported between January 1, 2020 and December 31, 2021 [1]. At least 220 patients with SARS-CoV-2 associated GBS were already reported between January 1, 2020 and December 31, 2020 [2]. In the first half of 2021 another eighty patients with SARS-CoV-2 associated GBS were published [Finsterer, submitted]. Therefore, SARS-CoV-2 associated GBS is far more common than indicated in the review. We disagree with the statement in the abstract that PNS complications secondary to COVID-19 vaccines mainly include cases of GBS, Bell's palsy, and cases of neuralgic amyotrophy [1]. In a recent review of the neurological side effects of SARS-CoV-2 vaccinations, >3000 patients with headache, 389 with GBS, 312 with venous sinus thrombosis (VST), 11 patients with transverse myelitis, and <5 patients each with facial nerve palsy, small fiber neuropathy, autoimmune encephalitis, reversible cerebral vasoconstriction syndrome (RCVS), multiple sclerosis, neuromyelitis optica spectrum disorder (NMO-SD), ischemic stroke, intracerebral bleeding, Tolosa-Hunt syndrome, hypophysitis, ventriculitis, hyperactive encephalopathy, and acute disseminated encephalomyelitis had been reported [3]. We disagree that PNS manifestations of neuro-COVID include only isolated cranial nerve palsies, GBS, autoimmune plexitis, vasculitic neuropathy, CIDP, myasthenia, myositis, and critical ill neuropathy. PNS lesions not included in the review include small fiber neuropathy, pressure palsies due to bedding on the intensive care unit (ICU), myasthenic syndrome, dermatomyositis, and trigeminal neuropathy [4]. The review did not discuss the PNS side effects of various drugs commonly given to patients with severe COVID-19, such as chloroquine, tocilizumab, remdesivir, ritonavir, lopinavir, steroids, and various antibiotics. Toxic neuropathy, rhabdomyolysis due to the neurotoxic or myotoxic effect of anti-SARS-CoV-2 drugs should be included in a review of the PNS complications of SARS-CoV-2 infections. Overall, the interesting study has some limitations and inconsistencies that call the results and their interpretation into question. Discussing these limitations might enrich the conclusions and their practical implications. The spectrum of neuro-COVID of the PNS is broader than commonly assumed.