Acute Flaccid Myelitis in COVID-19

Abdelhady, Mazen; Elsotouhy, Ahmed; Vattoth, Surjith

doi:10.1259/bjrcr.20200098

Cited by 33 publications

(81 citation statements)

References 6 publications

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“…The symptoms of our rst case happened abruptly 7 days after acute symptoms of COVID-19 and were severe in nature and the patient had poor treatment outcome. These symptoms were very similar to previous cases of COVID-19 related transverse myelitis reported by Kang Zhao et al, Abdelhady et al and Alketbi et al (12)(13)(14) The abrupt onset of symptoms in these cases was similar to spinal cord infarction. Furthermore neck or back pain is another symptom of cord infarction and this symptom was declared by our patient.…”

Section: Discussionsupporting

confidence: 90%

Transverse myelitis in COVID-19 patients: Report of two cases

Advani

Zali

Ommi

et al. 2020

Preprint

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Background: COVID-19 has been associated with several neurological complications. One of these complications is transverse myelitis. Several cases of acute transverse myelitis are reported in association with this disease among the world. As there is lack of knowledge about the association of COVID-19 and myelitis and the clinical features of this complication are still ambiguous, we report two patients with transverse myelitis following COVID-19 infection. Patients: This study was performed in a referral center of COVID-19 in Iran(Shohada Tajrish hospital) and two patients with paraparesis and diagnosis of transverse myelitis were enrolled. Both patients had longitudinally extensive transverse myelitis that resulted in paraparesis. One of the patients had favorable outcome after treatment with plasma exchange but the other had no improvement following treatment.Conclusion: Transverse myelitis could be a complication of COVID-19 and infarction and inflammation could be suggested as probable mechanisms for this condition.

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Section: Discussionsupporting

confidence: 90%

Transverse myelitis in COVID-19 patients: Report of two cases

Advani

Zali

Ommi

et al. 2020

Preprint

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“…After review of the 242 documents, we identified 430 patients with COVID-19 diagnosed based on PCR or serologic testing who had acute neurological symptoms prompting CSF testing [ [5] , [6] , [7] , [8] , [9] , [10] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , …”

Section: Resultsmentioning

confidence: 99%

Cerebrospinal fluid in COVID-19: A systematic review of the literature

Lewis

Frontera

Placantonakis

et al. 2021

Journal of the Neurological Sciences

150

152

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We sought to review the literature on cerebrospinal fluid (CSF) testing in patients with COVID-19 for evidence of viral neuroinvasion by SARS-CoV-2. Methods: We performed a systematic review of Medline and Embase between December 1, 2019 and November 18, 2020 to identify case reports or series of patients who had COVID-19 diagnosed based on positive SARS-CoV-2 polymerase chain reaction (PCR) or serologic testing and had CSF testing due to a neurologic symptom. Results: We identified 242 relevant documents which included 430 patients with COVID-19 who had acute neurological symptoms prompting CSF testing. Of those, 321 (75%) patients had symptoms that localized to the central nervous system (CNS). Of 304 patients whose CSF was tested for SARS-CoV-2 PCR, there were 17 (6%) whose test was positive, all of whom had symptoms that localized to the central nervous system (CNS). The majority (13/17, 76%) of these patients were admitted to the hospital because of neurological symptoms. Of 58 patients whose CSF was tested for SARS-CoV-2 antibody, 7 (12%) had positive antibodies with evidence of intrathecal synthesis, all of whom had symptoms that localized to the CNS. Of 132 patients who had oligoclonal bands evaluated, 3 (2%) had evidence of intrathecal antibody synthesis. Of 77 patients tested for autoimmune antibodies in the CSF, 4 (5%) had positive findings. Conclusion: Detection of SARS-CoV-2 in CSF via PCR or evaluation for intrathecal antibody synthesis appears to be rare. Most neurological complications associated with SARS-CoV-2 are unlikely to be related to direct viral neuroinvasion.

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“…Complete recovery was seen in 1/18(5.6%) ( Chow et al, 2020 ), moderate improvement in 5/18 (27.7%) ( Zhou et al, 2019 ; Novi et al, 2020 ; Munz et al, 2020 ; Sarma et al, 2020 ; AlKetbi et al, 2020 ), mild improvement in 9/18(50.0%) ( Zoghi et al, 2020 ; Maideniuc et al, 2020 ; Valiuddin et al, 2020 ; Masuccio et al, 2020 ; Zachariadis et al, 2020 ; Águila-Gordo et al, 2020 ; Sotoca et al, 2020 ; Baghbanian et al, 2020 ), no improvement in 1/18(5.6%) ( Kaur et al, 2020 ) and 2 deaths (11.1%) ( Chakraborty et al, 2020 ; Abdelhady et al, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

Para-infectious anti-GD2/GD3 IgM myelitis during the Covid-19 pandemic: Case report and literature review

Antonio

Suárez

Fernández-Barriuso

et al. 2021

Multiple Sclerosis and Related Disorders

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Background: Even though SARS-CoV-2 is a predominantly respiratory virus, several reports have described various neurological disorders, from the beginning of the pandemic. The first para-infectious myelitis case was described in Wuhan in February 2020. Nevertheless, data from registries and reviews are scarce. Methods: A 40-year-old female with T5-T6 SARS-CoV-2 para-infectious myelitis is reported. A literature review of the published literature on the SARS-CoV-2 and para-infectious myelitis was done. Epidemiological, clinical, laboratory, image, treatment, and outcome data are described. Results: Particular findings of our case are that Covid-19 was asymptomatic and anti-GD2/GD3 IgM was found. 18 para-infectious myelitis occurred over a wide age range (Beh et al., 2013-67), mean age 50.7±18.6 years, with 10/18 (55.6%) women. Covid-19 involvement was variable from asymptomatic cases to severe Covid-19 resulting in death. The mean time to establish myelitis from the onset of Covid-19 symptoms was 10.3 ±7.8 days (0-24). The most common clinical form was transverse myelitis (14/18 patients, 77.7%) and the most frequent radiological form was longitudinally extensive myelitis (11/17 patients, 64.7%). In CSF mild lymphocytosis (14/16, 87.5%) with low cellularity (40.9±49.7/μL) and elevated proteins (11/16, 77.8%, mean 145.0 mg±159.0/dL) were frequent. Oligoclonal bands were usually negative (7/9, 77.7%) and mirror pattern was found in 2/7 patients (33.3%). SARS-CoV-2 PCR in CSF was negative in 10/10 cases. Conclusion: SARS-CoV-2 can cause myelitis by immune-mediated mechanisms. Clinical-radiological characteristics of Covid-19 para-infectious myelitis were variable and non-specific.

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Acute Flaccid Myelitis in COVID-19

Cited by 33 publications

References 6 publications

Transverse myelitis in COVID-19 patients: Report of two cases

Transverse myelitis in COVID-19 patients: Report of two cases

Cerebrospinal fluid in COVID-19: A systematic review of the literature

Para-infectious anti-GD2/GD3 IgM myelitis during the Covid-19 pandemic: Case report and literature review

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Acute Flaccid Myelitis in COVID-19

Cited by 33 publications

References 6 publications

Transverse myelitis&nbsp;in COVID-19 patients: Report of two cases

Transverse myelitis&nbsp;in COVID-19 patients: Report of two cases

Cerebrospinal fluid in COVID-19: A systematic review of the literature

Para-infectious anti-GD2/GD3 IgM myelitis during the Covid-19 pandemic: Case report and literature review

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Transverse myelitis in COVID-19 patients: Report of two cases

Transverse myelitis in COVID-19 patients: Report of two cases