tetano
Editor, Senior Moderator
Spinal Cord Ser Cases
. 2020 Sep 30;6(1):92.
doi: 10.1038/s41394-020-00341-x.
Spinal cord dysfunction after COVID-19 infection
Gianluca Sampogna[SUP] 1 2 [/SUP], Noemi Tessitore[SUP] 1 [/SUP], Tatiana Bianconi[SUP] 1 [/SUP], Alessandra Leo[SUP] 1 [/SUP], Michele Zarbo[SUP] 1 [/SUP], Emanuele Montanari[SUP] 2 [/SUP], Michele Spinelli[SUP] 3 [/SUP]
Affiliations
Abstract
Introduction: We observed individuals affected by spinal cord dysfunction (SCD) after coronavirus disease 2019 (COVID-19). The aim of our report is to provide our initial experience with individuals experiencing SCD after COVID-19 in a referral center in Northern Italy, from February 21 to July 15, 2020.
Case presentation: We report on three men with SCD after COVID-19. Case 1, aged 69 years, experienced T10 AIS B paraplegia upon awakening due to spinal cord ischemia from T8 to conus medullaris, besides diffuse thromboses, 27 days after the onset of COVID-19 symptoms. Case 2, aged 56 years, reported progressive cervicalgia 29 days after COVID-19 onset associated with C3 AIS C tetraplegia. Magnetic resonance imaging (MRI) revealed a C4-C6 spinal epidural abscess (SEA) requiring a C3-C4 left hemilaminectomy. Case 3, aged 48 years, reported backache together with lower limb muscle weakness on day 16 after being diagnosed with COVID-19. Exam revealed T2 AIS A paraplegia and an MRI showed a T1-T7 SEA. He underwent a T3-T4 laminectomy. Prior to SCD, all three individuals suffered from respiratory failure due to COVID-19, required mechanical ventilation, had cardiovascular risk factors, experienced lymphopenia, and received tocilizumab (TCZ).
Discussion: To our knowledge, this is the first report of SCD after COVID-19. Based on our experience, we did not observe a direct viral infection, but there were two different etiologies. In Case 1, the individual developed spinal cord ischemia, whereas in Cases 2 and 3 SEAs were likely related to the use of TCZ used to treat COVID-19.
. 2020 Sep 30;6(1):92.
doi: 10.1038/s41394-020-00341-x.
Spinal cord dysfunction after COVID-19 infection
Gianluca Sampogna[SUP] 1 2 [/SUP], Noemi Tessitore[SUP] 1 [/SUP], Tatiana Bianconi[SUP] 1 [/SUP], Alessandra Leo[SUP] 1 [/SUP], Michele Zarbo[SUP] 1 [/SUP], Emanuele Montanari[SUP] 2 [/SUP], Michele Spinelli[SUP] 3 [/SUP]
Affiliations
- PMID: 32999271
- DOI: 10.1038/s41394-020-00341-x
Abstract
Introduction: We observed individuals affected by spinal cord dysfunction (SCD) after coronavirus disease 2019 (COVID-19). The aim of our report is to provide our initial experience with individuals experiencing SCD after COVID-19 in a referral center in Northern Italy, from February 21 to July 15, 2020.
Case presentation: We report on three men with SCD after COVID-19. Case 1, aged 69 years, experienced T10 AIS B paraplegia upon awakening due to spinal cord ischemia from T8 to conus medullaris, besides diffuse thromboses, 27 days after the onset of COVID-19 symptoms. Case 2, aged 56 years, reported progressive cervicalgia 29 days after COVID-19 onset associated with C3 AIS C tetraplegia. Magnetic resonance imaging (MRI) revealed a C4-C6 spinal epidural abscess (SEA) requiring a C3-C4 left hemilaminectomy. Case 3, aged 48 years, reported backache together with lower limb muscle weakness on day 16 after being diagnosed with COVID-19. Exam revealed T2 AIS A paraplegia and an MRI showed a T1-T7 SEA. He underwent a T3-T4 laminectomy. Prior to SCD, all three individuals suffered from respiratory failure due to COVID-19, required mechanical ventilation, had cardiovascular risk factors, experienced lymphopenia, and received tocilizumab (TCZ).
Discussion: To our knowledge, this is the first report of SCD after COVID-19. Based on our experience, we did not observe a direct viral infection, but there were two different etiologies. In Case 1, the individual developed spinal cord ischemia, whereas in Cases 2 and 3 SEAs were likely related to the use of TCZ used to treat COVID-19.