COVID-19 and spinal cord injury and disease: results of an international survey as the pandemic progresses

Abstract

Study design An online survey. Objectives To follow-up with and re-query the international spinal cord community's response to the Coronavirus Disease 2019 (COVID-19) pandemic by revisiting questions posed in a previous survey and investigating new lines of inquiry. Setting An international collaboration of authors and participants. Methods Two identical surveys (one in English and one in Spanish) were distributed via the internet. Responses from both surveys were pooled and analyzed for demographic and response data. Results Three hundred and sixty-six respondents were gathered from multiple continents and regions. The majority (63.1%) were rehabilitation physicians and only 12.1% had patients with spinal cord injury/disease (SCI/D) that they knew had COVID-19. Participants reported that the COVID-19 pandemic had caused limited access to clinician and support services and worsening medical complications. Nearly 40% of inpatient clinicians reported that "some or all" of their facilities' beds were being used by medical and surgical patients, rather than by individuals requiring inpatient rehabilitation. Respondents reported a 25.1% increase in use of telemedicine during the pandemic (35% used it before; 60.1% during), though over 60% felt the technology incompletely met their patients' needs. Conclusion The COVID-19 pandemic has negatively impacted the ability of individuals with SCI/D to obtain their "usual level of care." Moving forward into a potential "second wave" of COVID-19, patient advocacy and efforts to secure access to thorough and accessible care are essential.

What happens post‐lockdown for people with disability? Autonomy, quality of life, service access and health changes for people with spinal cord injury in Victoria, Australia after COVID ‐19 social distancing restrictions

“…Regardless, as research has confirmed that poor access to health services during the pandemic can contribute to increased secondary health issues for people with SCI, it is possible that the referenced conditions were a result of being unable to receive allied health and specialist support. For example, a survey of rehabilitation clinicians confirmed that during the pandemic clients with SCI had limited access to essential health services, and experienced increased medical complications (Gustafson et al, 2021 ). Furthermore, cross‐sectional work eliciting the opinions of people with SCI during the pandemic has confirmed poor access to health services and increased secondary complications as concerns (Hearn et al, 2021 ).…”

Clinical features and prognosis of COVID-19/SARS-CoV-2 infections in persons with spinal cord injury: a review of current literature

“…Increased spasticity (10.3%) and rigour (6.9%) were also reported as atypical presentations of COVID-19. Similarly, Gustafson et al [ 35 ] conducted another online international survey from May 21, 2020 to June 10, 2020, to assess the health care professionals’ experiences, knowledge and concerns of the COVID-19 pandemic SCI. Three hundred and sixty-six professionals (among them 63.1% were rehabilitation physicians) participated.…”

“…Out of 366 professionals, only 12.1% responded that they had patients with SCI with COVID-19 infection. In this review [ 35 ], the most frequently cited presenting symptoms were fever (7.9%), shortness of breath (6.8%), sweats (1.6%), increased spasticity (1.6%), increased pain (1.4%), rash/peripheral lesions (1.4%) and anosmia (1.1%). In both surveys [ 34 , 35 ]), the cough was not reported as a common presenting feature of COVID pneumonia in SCI.…”

“…In this review [ 35 ], the most frequently cited presenting symptoms were fever (7.9%), shortness of breath (6.8%), sweats (1.6%), increased spasticity (1.6%), increased pain (1.4%), rash/peripheral lesions (1.4%) and anosmia (1.1%). In both surveys [ 34 , 35 ]), the cough was not reported as a common presenting feature of COVID pneumonia in SCI. In their case-control study, D’ Andrea et al [ 22 ] evaluated the differences in clinical features and evolution of COVID-19 between persons with SCI and normal health care workers.…”

The COVID-19 Pandemic Related Lived Experiences of Individuals With a Spinal Cord Injury/Disease

“…There is also a fear of having to attend hospitals, but non-attendance could lead to greater complications of untreated conditions. Attempts to address some of these issues include the increased use of telehealth to reduce the need for in-person appointments with doctors and physical therapists ( 9 ).…”