The etiological agent of coronavirus disease-19 (COVID-19), SARS-coronavirus-2 (SARS-CoV-2), emerged in Wuhan, China, and quickly spread worldwide leading the World Health Organization (WHO) to recognize it not only as a pandemic but also as an important thread to public health. Beyond respiratory symptoms, new neurological manifestations are being identified such as headache, ageusia, anosmia, encephalitis or acute cerebrovascular disease. Here we report the case of an acute transverse myelitis (TM) in a patient with SARS-CoV-2 infection detected by the nasopharyngeal swab technique but not in cerebrospinal fluid (CSF) analysis. Anti-herpes simplex virus (HSV) 1 and varicella-zoster IgM antibodies were not detected in serum samples and spinal and brain magnetic resonance imaging (MRI) showed no abnormal findings. This case remarks that COVID-19 nervous system damage could be caused by immune-mediated mechanisms.

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Introduction Concerns have been raised about the possible harmfulness of angiotensin-converter enzyme inhibitors (ACEi) and aldosterone receptor blockers (ARB) in patients with COVID-19. However, few data from a European population have been published, especially from hypertensive patients. Aim To study the association between ACEi or ARB treatments and major adverse outcomes during hospitalisation in COVID-19 patients. Methods We studied 545 consecutive hypertensive patientsadmitted to our institution due to COVID-19 with respiratory involvement. Weanalysed the incidence of combined event (death or mechanical ventilatorysupport) during hospitalisation, as well as the time to independent events. Results 188 (34.5%) patients presentedthe combined endpoint. 182 (33.4%) patients died, and 21 (3.9%) neededmechanical ventilatory support. Patients with previous treatment with ACEi orARB presented similar incidence of the combined endpoint during hospitalisation(31.6% vs. 41.8%; p = 0.08), with a lower all-cause mortality rate (30.4% vs. 41.2%;p = 0.03) compared with those without prior treatment. Use of ACEi or ARB was not independentlyassociated with lower incidence of the combined endpoint [Adjusted OR 0.675 (95% CI 0.298-1.528; p = 0.146)], but it was associated with lower mortality [Adjusted OR 0.550 (95% CI 0.304-0.930; p = 0.047)]. Conclusions The use of ACEi or ARB was associated with lessincidence of all-cause death during hospitalisation among hypertensive patientsadmitted with COVID-19 respiratory infection.