Spinal cord infarction attributed to SARS-CoV-2, with post-acute sequelae of COVID-19: A case report

World Journal of Clinical Cases, 2023 · DOI: 10.12998/wjcc.v11.i36.8542 · Published: December 26, 2023

Simple Explanation

This case report describes a 70-year-old woman who experienced a spinal cord infarction after contracting SARS-CoV-2, the virus that causes COVID-19. The infarction led to sensorimotor loss in her trunk and lower extremities. The patient's symptoms included myalgias, neuropathic pain, spasticity, bladder spasms, and frequent urinary tract infections. These symptoms were more severe and frequent compared to other spinal cord injury patients. The patient's case is unique because she developed post-acute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID, which further complicated her condition and recovery.

Study Duration

3 years

Participants

One 70-year-old female

Evidence Level

Level 4, Case Report

Key Findings

1
Spinal cord infarction can occur as a rare complication following acute SARS-CoV-2 infection, leading to significant neurological disability.
2
The combination of spinal cord injury and PASC can result in increased symptom severity, including myalgias, neuropathic pain, muscle spasms, and frequent bacterial infections.
3
Exacerbations of underlying conditions like undifferentiated connective tissue disease (UCTD) can be triggered by complications of spinal cord injury, such as urinary tract infections and bowel dysfunction.

Research Summary

This case report describes a 70-year-old female who developed a spinal cord infarction attributed to acute SARS-CoV-2 infection, resulting in paraplegia and subsequent post-acute sequelae of COVID-19 (PASC). The patient experienced severe neurological disability, with symptoms such as myalgias, neuropathic pain, muscle spasms, and frequent bacterial infections, which were exacerbated by the presence of PASC. The case highlights the challenges of managing patients with both spinal cord injury and PASC, as well as the potential for complications of SCI to trigger exacerbations of underlying conditions.

Practical Implications

Increased Awareness

Clinicians should be aware of the possibility of spinal cord infarction as a rare complication of SARS-CoV-2 infection.

Comprehensive Management

Management of patients with spinal cord injury and PASC requires a comprehensive approach that addresses both conditions and minimizes exacerbations of underlying diseases.

Long-term Care

Long-term care for SCI patients should consider potential COVID-19 concerns

Study Limitations

1
Single case report limits generalizability.
2
Lack of DWI sequences on MRI limits assessment of localized edema after infarct.
3
Patient's UCTD may have influenced the presentation and course.

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