Author: Mondal, Ritwick; Deb, Shramana; Shome, Gourav; Ganguly, Upasana; Lahiri, Durjoy; Benito-Leon, Julián
Title: COVID-19 and emerging spinal cord complications: A systematic review Cord-id: 392aa10n Document date: 2021_3_21
ID: 392aa10n
Snippet: BACKGROUND: : Spinal cord complications associated with coronavirus infectious disease of 2019 (COVID-19) are being widely reported. The purpose of this systematic review was to summarize so far available pieces of evidence documenting novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) mediated spinal cord demyelinating diseases. METHODS: : We used the existing PRISMA consensus statement. Data were collected from PubMed, NIH Litcovid, EMBASE and Cochrane library databases, as well
Document: BACKGROUND: : Spinal cord complications associated with coronavirus infectious disease of 2019 (COVID-19) are being widely reported. The purpose of this systematic review was to summarize so far available pieces of evidence documenting novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) mediated spinal cord demyelinating diseases. METHODS: : We used the existing PRISMA consensus statement. Data were collected from PubMed, NIH Litcovid, EMBASE and Cochrane library databases, as well as Pre-print servers (medRxiv, bioRxiv, and pre-preints.org), until September 10, 2020, using pre-specified searching strategies. RESULTS: : The 21 selected articles were all case reports and included 11 (52%) men and 10 (48%) women. The mean age was of 46.7±18.0.The neurological manifestations included weakness, sensory deficit, autonomic dysfunction, and ataxia. In most cases, elevated cerebrospinal fluid protein as well as lymphocytic pleocytosis were found. SARS-CoV-2 was detected in five (24%) patients, meanwhile in 13 (62%) patients, the testing was negative. Testing was not performed in two cases and, in one, data were unavailable. Nearly half of the cases (N=9) were associated with isolated long extensive transverse myelitis (LETM), whereas a combination of both LETM and patchy involvement was found in two. Only five patients had isolated short segment involvement and two patchy involvement. Furthermore, concomitant demyelination of both brain and spine was reported in six patients. Concerning the prognosis, most of the patients improved and the mortality rate was low (N = 2, <10%). CONCLUSION: : Spinal cord demyelination should be added to the plethora of immune mediated neurologic complications associated with COVID-19.
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