Spinal cord involvement in COVID-19: A review

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2021.1888022 · Published: January 1, 2021

Simple Explanation

COVID-19 can affect the spinal cord, leading to various neurological issues. This review looks at reported cases of spinal cord disorders related to the SARS-CoV-2 virus to understand their characteristics and outcomes. The review found several spinal cord issues linked to COVID-19, including transverse myelitis and other related conditions. These problems may arise from the virus directly affecting the spinal cord or from the body's immune response. Many patients with COVID-19-related spinal cord problems did not fully recover, often experiencing lasting weakness. More research is needed to understand and effectively treat these complications.

Study Duration

Not specified

Participants

33 isolated cases

Evidence Level

Level 4, case series review

Key Findings

1
COVID-19-related spinal cord manifestations include acute transverse myelitis, acute necrotizing myelitis, SARS-CoV-2 myelitis, acute disseminated encephalomyelitis and others.
2
The possible mechanisms of spinal cord involvement include direct viral invasion, cytokine storm, coagulopathy, and an autoimmune response.
3
Treatment responses have been generally unsatisfactory, with many patients experiencing residual weakness and requiring long-term rehabilitation.

Research Summary

This review examines spinal cord disorders associated with SARS-CoV-2, finding a variety of manifestations like acute transverse myelitis and acute necrotizing myelitis. The mechanisms of spinal cord involvement may include direct viral invasion, cytokine storm, coagulopathy, and autoimmune response. Treatment outcomes have been generally unsatisfactory, with many patients experiencing residual weakness necessitating long-term rehabilitation.

Practical Implications

Diagnostic Awareness

COVID-19 should be considered in the differential diagnosis of acute myelitis, even in the absence of respiratory symptoms.

Pathophysiology Elucidation

Further research is needed to fully understand the mechanisms by which SARS-CoV-2 affects the spinal cord.

Rehabilitation Strategies

Given the high rate of residual weakness, long-term rehabilitation strategies are crucial for patients with COVID-19-associated myelopathies.

Study Limitations

1
The review is based on a limited number of case reports.
2
Treatment response data is variable and often unsatisfactory.
3
Lack of autopsy examinations limits the characterization of the pathophysiology of spinal cord complications.

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