Dear editor A 53-year-old female was admitted to the neurology ward of Booalisina hospital Sari, Iran after suffering from paraparesis for 2 days. The patient's symptoms started with distal left limb involvement, and after a few hours, the right lower limb was also involved. The symptoms were fully established within 2 days. Three days before the weakness of the lower limbs, the patient suffered from radicular low back pain and transient urinary incontinence. The patient had a history of diabetes mellitus, hypertension, and ischemic heart disease. The systemic examination was normal. Her neurological examination demonstrated asymmetrical hypotonic paraparesis 3/5 power in the proximal and distal part of the right lower limbs and 0/5 power in the proximal and distal part of left lower limbs with areflexia and bilateral Babinski sign. Sensory examination revealed a sensory level at T11-T12 to pinprick testing and bilateral position test impairment in the bilateral lower extremities. The tendon reflexes in both upper limbs and cranial nerve examination were normal. 2 weeks before, the patient had been admitted and treated for COVID-19 and at that time the results of coronavirus RNA nasopharyngeal swab reported positive. Chest CT revealed a patchy ground-glass consolidation in the middle and lower lobes of the right lung (Fig. 1). CSF testing showed 13 cells predominantly lymphocytes with normal protein and glucose. CSF OCB reported negative and the IgG index was in the upper limit of normal (0.71).

This study suggests that injection of MSC can be a suitable method, especially for secondary-progressive patients. It seems that reinjection of these stem cells can be safe and sustaining it positively increases the effects of this therapeutic approach.

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