Spinal cord infarction in a 41-year-old male patient with COVID-19

Eissa, Mamdouh A.; Abdelhady, Mazen; Alqatami, Hosam; Salem, Khaled; Own, Ahmed; Beltagi, Ahmed El

doi:10.1177/1971400921988925

Cited by 9 publications

(7 citation statements)

References 11 publications

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“…In this regard, SARS-CoV-2 infection is known to lead to late infection and/or post-infection damage to the central nervous system. The brain can be affected, with post-acute viral encephalitis [ 3 ], but so can the spinal cord, with inflammation or infarction [ 4 ]. In these cases, a prolonged inflammatory response, high interleukin-6 levels and a negative RT-PCR test are demonstrated and could explain the clinical findings [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Association between Long COVID and Overweight/Obesity

Vimercati

Maria

Quarato

et al. 2021

JCM

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Background: Long COVID is a syndrome characterized by the persistence of SARS-CoV-2 infection symptoms. Among HCWs, prolonged COVID symptoms could lead to the inability to perform work tasks. The aim of this study is to investigate 35-day long-COVID (35-LC) characteristics and risk factors in a one-year period. Methods: We carried out a retrospective cohort study during the COVID-19 pandemic at University Hospital of Bari. A total of 5750 HCWs were tested for close contact with a confirmed case, in the absence of personal protective equipment, or for symptom development. Results: Each positive HCW was investigated for cardiovascular risk factors or respiratory diseases. An amount of 352 HCWs (6.1%) were infected by SARS-CoV-2, and 168 cases evolved to long COVID. The 35-LC group showed mean BMI values higher than the non-35-LC group (25.9 kg/m2 vs. 24.8 kg/m2, respectively), and this difference was significant (p-value: 0.020). Moreover, HCWs who suffered from pulmonary disease (OR = 3.7, CL 95%: 1.35–10.53; p-value = 0.007) or overweight (OR = 1.6 CL 95%: 1.05–2.56; p-value = 0.029) had an increased risk of developing 35-LC. Conclusions: Long COVID is an emerging problem for hospital managers as it may reduce the number of HCWs deployed in the fight against COVID-19. High BMI and previous pulmonary disease could be risk factors for 35-LC development in exposed HCWs.

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Section: Introductionmentioning

confidence: 99%

Association between Long COVID and Overweight/Obesity

Vimercati

Maria

Quarato

et al. 2021

JCM

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“…A total of 58 patients with spinal cord involvement have been described in two recent reviews (Garg et al, 2021;Mondal et al, 2021) Sampogna et al, 2020). Some potential mechanisms for spinal cord involvement might be a direct viral invasion (Eissa et al, 2021), cytokine storm (Tang and Zheng, 2022), coagulopathy (Szegedi et al, 2020), or an autoimmune response, which induced a demyelinating disease after a SARS-CoV-2 infection (Khair et al, 2022), mediated by either direct neurotropism or an aberrant immune-mediated injury.…”

Section: Discussionmentioning

confidence: 99%

“…These complications affected both the central and peripheral nervous systems (Ellul et al, 2020;Nath, 2020;Studart-Neto et al, 2020). Although spinal cord involvements have been widely reported, the complications seem to be relatively rare (Eissa et al, 2021;Garg et al, 2021;Case Report Braglia L et al, 2022;3(5) Sampogna et al, 2020). This case report describes a 44-year-old female that developed abrupt symptomatology, including lower-limb paralysis with sensory involvement at the T12 level, two weeks after the resolution of COVID-19 bilateral pneumonia.…”

Section: Introductionmentioning

confidence: 91%

Acute Spinal Cord Dysfunction Following COVID-19 Infection: A Case Report

Braglia¹,

Vandelli²,

Manenti³

et al. 2022

FMCR

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Here, we describe a 44-year-old female that developed abrupt symptomatology, including lower-limb paralysis with sensory involvement at the T12 level, two weeks after the resolution of COVID-19 bilateral pneumonia. Based on the neurological symptoms and the neurophysiological investigations, a clinical diagnosis of thoracic spinal cord dysfunction was made. However, all the complementary tests performed showed normal results. In particular, repeated MRIs showed no alterations; the cerebrospinal fluid analysis showed normal results: the CT scan of the brain was normal and the CT scan of the abdominal and thoracic aorta showed a normal size and course. Cases of spinal cord involvement have rarely been described, in which the MRIs never revealed cord signaling changes. We hypothesize that a small vessel spinal cord stroke might explain the pathogenesis and the absence of changes detectable on an MRI along with the patient's modest recovery during the long follow up. However, it cannot be excluded that the severe clinical course of SARS-CoV-2 infection, may suggest other different etiologies that could be related to prolonged hospitalization.

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“…Some patients may develop microhemorrhages 44,45 and have other signs of microvascular injury 46 . Spinal cord infarcts have also been reported 47,48 …”

Section: Neurologic Complications Of Covid-19mentioning

confidence: 99%

“…46 Spinal cord infarcts have also been reported. 47,48 Cerebrovascular complications of COVID-19 are likely due to altered coagulation pathways, as demonstrated by observations of elevated D-dimer, increased prothrombin time, and activated partial thromboplastin time, and disseminated intravascular coagulation 49 ; anticoagulants are frequently used in hospitalized patients with elevated D-dimer levels (CASE 11-2). The Virchow triad consists of endothelial cell injury, hypercoagulable state, and immobility.…”

Section: Strokementioning

confidence: 99%

Neurologic Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection

Nath¹

2021

CONTINUUM: Lifelong Learning in Neurology

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PURPOSE OF REVIEW: This article describes the spectrum of neurologic complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, their underlying pathology and pathogenic mechanisms, gaps in knowledge, and current therapeutic strategies.RECENT FINDINGS: COVID-19 is the clinical syndrome caused by the novel coronavirus SARS-CoV-2. It can affect the entire neuraxis, and presentations in the acute phase are variable, although anosmia is a common manifestation. Encephalopathy is common in patients who are hospitalized and is often associated with multiorgan involvement. Immune-mediated encephalitis is probably underrecognized; however, viral encephalitis is rare. Other manifestations include stroke, seizures, myelitis, and peripheral neuropathies, including Guillain-Barré syndrome, which sometimes has atypical manifestations. Treatment is symptomatic, and immunotherapies have been used successfully in some patients. Long-term complications include dysautonomia, exercise intolerance, malaise, sleep disturbances, cognitive impairment, and mood disorders. SUMMARY: Neurologic manifestations of COVID-19 may occur in the acute setting and may be independent of respiratory manifestations. Immune-mediated syndromes and cerebrovascular complications are common. Large populations of patients are expected to have long-term neurologic complications of COVID-19, many of which may emerge only after recovery from the acute illness.

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Spinal cord infarction in a 41-year-old male patient with COVID-19

Cited by 9 publications

References 11 publications

Association between Long COVID and Overweight/Obesity

Association between Long COVID and Overweight/Obesity

Acute Spinal Cord Dysfunction Following COVID-19 Infection: A Case Report

Neurologic Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection

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