A 77-year-old man from Japan who tested positive for COVID-19 was being treated at Tokyo Medical University Hospital before beginning to experience 'restless and deep anal discomfort.'
Restless anal syndrome
The man in question recovered fairly quickly and only experienced very mild symptoms of the coronavirus. After regaining health, the elderly man was said to suffer insomnia and anxiety—something he had never had a problem with in the past. This prompted doctors to take a closer look at what was happening. Dr Itaru Nakamura explained that:
Several weeks after discharge, he gradually began to experience restless, deep anal discomfort, approximately 10 cm from the perineal region. The following features were observed in the anal region; urge to move is essential, with worsening with rest, improvement with exercise, and worsening at evening.
Neurological findings including deep tendon reflex, perineum loss of sensory and spinal cord injury, revealed no abnormalities. Exercise such as walking or running... made the symptoms relief [sic], while taking a rest made the symptom worsen.
A first for the coronavirus
Now, for the first time ever, doctors are linking COVID-19 with restless anal syndrome—a variant of the condition restless leg syndrome. The latter tends to cause people who suffer from the condition to feel an overwhelming urge to constantly move their legs as a result of a fault in their nervous system. Dr. Itaru Nakamura concluded that:
We reported a case presenting with restless anal syndrome following affection of Covid-19 as restless legs syndrome variant. This case fulfilled 4 essential features of RLS: urge to move, worsening with rest, improvement with exercise, and worsening at evening.
To date, no case of restless anal syndrome associated with Covid-19 has been previously published. This case report may reflect the associative impacts of Covid-19 on the neuropsychiatric state.
The long-term outcomes of neuropsychiatric conditions should continue to be monitored.