Restless Leg Syndrome Is A Rare Presenting Feature Of COVID-19

There have been several known neurologic manifestations of COVID-19, such as headache, anosmia, etc. Rare cases of restless legs syndrome (RLS) associated with the disease have been reported. Here, the authors describe a patient with six-day nighttime discomfort in both legs that improved with moving them, with dry cough and myalgia added to her symptoms and she was hospitalized due to low oxygen saturation and suspicion of COVID-19. During hospitalization, antiviral and anti-inflammatory drugs were used and after a short time of discharge, RLS was eliminated without any specific drug. We hypothesize that since angiotensin-converting enzyme (ACE2) is highly expressed in Substantia Nigra, SARS-Cov-2 may disturb iron metabolism and homeostasis of dopaminergic neurons which leads to the development of RLS and inflammation exacerbates the condition.