COVID-19 in spinal cord injury patients at a veterans administration hospital: A case series

The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2020.1871254 · Published: December 31, 2020

Simple Explanation

This study reports on seven spinal cord injury (SCI) patients who tested positive for COVID-19 at a Veterans Affairs hospital in New York City during the spring of 2020. The researchers reviewed the patients' charts to gather information on their COVID-19 risk factors, how the illness presented, how it progressed, treatments used, and laboratory and radiological findings. The study found that pre-existing health conditions were better indicators of severe COVID-19 than the level or completeness of the spinal cord injury.

Study Duration

March 11, 2020 to June 24, 2020

Participants

Seven SCI veterans, all male, mean age 60.6

Evidence Level

Case series

Key Findings

1
Level and completeness of SCI did not appear to correlate with COVID-19 severity.
2
Pre-existing comorbidities are the most reliable predictors of severe SARS-CoV-2 infection in persons with chronic SCI.
3
Fever and cough, were common in this series, contrary to concerns that SCI may mask the cardinal signs of COVID-19.

Research Summary

This case series describes the clinical features and disease course of COVID-19 in seven veterans with spinal cord injury (SCI) treated at a single center during the COVID-19 pandemic. The study found that pre-existing comorbidities, rather than the level or completeness of SCI, were more reliable predictors of severe COVID-19 infection. The authors recommend vigilant surveillance screening for individuals with SCI, especially those undergoing prolonged hospitalization or those in long term care facilities.

Practical Implications

Preventive Strategies

SCI units should implement preventive strategies to facilitate early detection, prompt treatment, and minimized viral spread.

Comorbidity Management

Special consideration should be given to pre-existing comorbidities like CKD and COPD in future studies as potential prognostic factors for COVID-19 severity in SCI patients.

Surveillance Screening

Vigilant surveillance screening is recommended for individuals with SCI, especially those in long-term care, to detect and manage COVID-19 early.

Study Limitations

1
Cases 2 and 4–7, who were hospitalized at the time of the outbreak, did relatively better, possibly because they were monitored frequently and aggressively tested.
2
Cases 1 and 3, who had community onset, might represent a “tip of the iceberg” phenomenon, and a larger number of milder or asymptomatic community-onset infections in our population may have gone undetected.
3
IgM testing was not available for any patient due to laboratory limitations at the time of the study.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury