Acute myelitis after SARS-CoV-2 infection: a case report.

Kang Zhao; Jucun Huang; Dan Dai; Yuwei Feng; Liming Liu; Shuke Nie

The coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China in December 2019 1 . It has been confirmed that this disease is caused by a new type of enveloped RNA coronavirus B, which is named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 2 . As of March 5, 2020 , there were 96643 laboratory-confirmed cases worldwide, resulting in 3313 deaths. Studies have shown that the virus has 79% homology with SARS virus 3 , potential intermediate animal host is still unknown, it has been demonstrated this virus did not come directly from pangolins 4 . Researchers have confirmed that SARS-CoV-2 enters the human body through ACE2 receptors on the surface of human cells and causes disease 5 . ACE2 is expected to be a possible target for intervention and treatment of the disease. There are ACE2 receptors in type II alveolar epithelial cells of human lung, so it has become the main target of SARS-CoV-2 in the pathogenesis of COVID-19 6 . However, in the process of clinical diagnosis and treatment, it has been found that many critically ill patients have symptoms of multiple organ dysfunction, in addition to the lungs, liver and kidney damage is also very prominent, which may be related to the expression of ACE2 in hepatic bile duct cells and proximal renal tubules 7, 8 . ACE2 receptors are also expressed on the surface of spinal cord cells 9, 10 ，whether spinal cord neurons were implicated in the Covid-19 was still unknown. We report a patient with COVID-19 who suddenly developed acute myelitis after initial high fever, suggesting central nervous system (CNS) could be also attacked by SARS-CoV-2.