Case-fatality with coronavirus disease 2019 (COVID-19) in United States Veterans with spinal cord injuries and disorders

Rehabilitation and COVID-19: the Cochrane Rehabilitation 2020 rapid living systematic review. Update as of July 31st, 2020

“…The majority of studies published in July 2020 were based, according to sampling site, in the following World Health Organization regions: Europe (n=10) 4,5,7,8,15,17,18,20,22,24 , primarily in Italy (n=6) 4,5,7,15,18,20 the Americas (six in the United States of America 3,6,11,13,16,19 and one in Canada 12 ), Western Pacific (Singapore 23 , China 9,14,25 ); and the Eastern Mediterranean region (Egypt 21 , Saudi Arabia 10 ).…”

“…Due to the heterogeneity of studies, a meta-analysis was not appropriate. According to the OCEBM 2011 Levels of Evidence Table 26 , the majority (69.5%) were Level 4 6,[9][10][11][12][13][15][16][17][18][19][20][22][23][24][25] , and the remainder 30.5% were Level 3 [3][4][5]7,8,14,21 (Table I). No RCT was found in this update…”

“…Nineteen papers (83%) 4,[6][7][8][9][10][11][12][14][15][16][17][18][19][20][22][23][24][25] studied COVID-19 patients, mostly assessed in the acute (10 studies) 6,7,10,12,[15][16][17][18]20,22 or post-acute phase (eight studies) 4,8,9,11,14,19,23,24 ; only one study 25 concerned patients in chronic phase. The remaining four studies 3,5,13,21 reported data on the impact of COVID-19 on subjects with pre-existing health conditions (i.e., myasthenia gravis 13 , neuromuscular disease (NMD) 5 , Parkinson disease (PD) 21 , and spinal cord injuries and disorders (SCI/D) 3 ).…”

“…Eight papers (35%) 3,4,6,8,11,16,19,23 provided data about a specific rehabilitation setting: three acute 6,16,19 , one general post-acute 11 , three specialized post-acute 3,4,23 , and one home service 8 .…”

Initial assessment and management of respiratory infections in persons with spinal cord injuries and disorders in the COVID‐19 era

“…The case‐fatality rate of 19% for veterans with SCI/D was 2.4 times that of 7.7% in non‐SCI/D veterans. However, this rate is falsely elevated due to inability to capture COVID‐19 infections that go undetected if patients are asymptomatic or if mild symptoms are attributed to other common conditions causing fever in the SCI/D population (eg, urinary tract infections) 14 …”