The skin biopsy was performed on the foot, distal leg, and thigh, and it showed significantly decreased intraepidermal nerve fiber density (IENFD) in all three areas. The nerve conduction studies of peroneal motor, tibial motor, sural sensory, and superficial peroneal nerves were negative for large-fiber neuropathy. Blood tests, including complete metabolic panel, cell blood count, sedimentation rate, hemoglobin A1c, vitamin B12, vitamin B6, vitamin D, vitamin C, serum electrophoresis, and human immunodeficiency virus were within normal limits. The tests included detailed blood workup, nerve conduction study, and skin biopsy. The rest of the neurological examination was unremarkable. Neurological examination showed decreased temperature and light touch sensations with relatively intact vibration and proprioception sensations in the upper and lower limbs. Within 2 months, her symptoms had worsened such that they interfered with her daily activities. Her sense of taste returned, but she reported a tingling sensation in the tongue and a crawling feeling of tingling and/or shock-like sensation in the chest. She was referred to neurology 2 months after the presentation due to the worsening of her symptoms. Her initial symptoms were resolved within 7–10 days however, she developed a burning and tingling sensation in the feet and hands 2 weeks after the initial presentation. She was quickly diagnosed with COVID-19, and she was isolated and given supportive treatment. A 49-year-old female with no significant medical history initially presented with dry cough, congestion, fever, and loss of taste and smell.
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