A Case Series of Spinal Infections Following COVID-19: A Delayed Complication

Abstract

Spinal infection in the form of tuberculous vertebral osteomyelitis or pyogenic spondylodiscitis is a commonly associated state of an immunodeficient host from various pathologies. For example, secondary infections can be seen following coronavirus disease 2019 (COVID-19). We report three cases of different forms of spinal infections that occurred as delayed complications to recent COVID-19 infection. The first case is a 60-year-old female who was diagnosed with an epidural abscess presenting with severe back pain and bilateral lower limb weakness. The second case is an elderly male who was diagnosed with L3/L4 spondylodiscitis and presented with predominantly back pain and minimal leg symptom. The final case is a young female who was diagnosed with severe T5 tuberculous spondylitis and presented with a complete sensory and motor deficit from T5 below. All patients showed good improvement after surgery and antibiotic therapy. Patients treated for COVID-19 are at risk of spinal infection development due to multiple pathophysiologies. Treatment of these various forms of spinal infection remains difficult, and we encourage physicians to be vigilant for the development of these complications post COVID-19 infection.

Post-COVID-19 Spondylodiscitis: A Case Study and Review of the Literature

“…According to PRISMA diagram, the cases with fungal aethiology and the repots with bacterial SD and/or epidural abscess diagnosed over 12 weeks post-COVID-19 were excluded. [ 24 , 25 , 26 , 27 , 28 , 29 , 30 ].…”

Epidural Abscesses as a Complication of Interleukin-6 Inhibitor and Dexamethasone Treatment in a Patient with COVID-19 Pneumonia: A Case Report

“…Both had received tocilizumab, supporting the role of both COVID-19-related and drug-induced immunosuppression along with preexisting clinical factors as the reasons for secondary bacterial infection. Mohamed Ramlee et al [17] reported three cases of delayed spinal infections following a recent SARS-CoV-2 infection up to three months before the diagnosis. It was not reported whether the patients received any immunosuppressive COVID-19 treatment.…”