COVID-19-Associated Myelitis, Para/Post Infectious or Infectious Myelitis: A Case Report From the North of Iran

Abstract

Background: During the COVID-19 pandemic, besides the most prevalent respiratory and systemic symptoms, some neurological symptoms such as acute hemorrhagic necrotizing encephalopathy and myelitis associated with COVID-19 have been reported. It is suspected that COVID-19 involves different body systems via interaction with the ACE-2 (angiotensin-converting enzyme 2) receptor. As ACE2 is expressed on the surface of central nervous system cells, including the brain and spine, these kinds of manifestations are inevitable. Clinical Presentation and Intervention: Here we report a case of COVID-19 associated with acute myelitis in an infected patient in the north of Iran during the pandemic of COVID-19. He presented with paraparesis and urinary incontinence. Unfortunately, he did not respond to anti-inflammatory treatment. Conclusion: Para/Post Infectious myelitis could be a complication of COVID-19 infection.

Clinical Features, Laboratory, and Radiological Findings of Patients With Acute Inflammatory Myelopathy After COVID-19 Infection

“…Eight patients (30.8%) 11 – 13 , 17 , 19 – 21 , 25 presented demyelinating changes in “thoracic region only.” Demyelinating change in “cervical region only” was seen in six patients (23.1%). 18 , 26 – 28 , 30 , 31 Another 12 patients (46.1%) 14 – 16 , 22 – 26 , 29 , 38 , 40 , 41 showed demyelinating changes in both the cervical and thoracic regions.…”

“…The CSF analysis was done in 30 cases. Five patients 16 , 23 , 30 , 34 , 35 (17%) were CSF SARS-CoV-2 RT-PCR positive.…”

“…Longitudinally extensive transverse myelitis (≥3 vertebral segments) was detected in 22 patients (84.6%). 11 , 12 , 14 – 20 , 22 , 23 , 25 – 28 , 30 , 38 , 40 , 41 Among them ( n = 22), three had demyelinating changes in the entire spinal cord. 14 , 15 , 40 …”

Transverse myelitis after SARS‐CoV‐2 infection: Report of two cases with COVID‐19

“…Since early in the pandemic, several cases of acute transverse myelitis have been reported in association with COVID‐19 worldwide 10–14 . In this article, we describe two patients a 47‐year‐old man and a 67‐year‐old woman with transverse myelitis after infection with the SARS‐CoV‐2 virus, hospitalized in Shohada Tajrish Hospital, affiliated with Shahid Beheshti University of medical sciences.…”

“…Since early in the pandemic, several cases of acute transverse myelitis have been reported in association with COVID‐19 worldwide. 10 , 11 , 12 , 13 , 14 In this article, we describe two patients a 47‐year‐old man and a 67‐year‐old woman with transverse myelitis after infection with the SARS‐CoV‐2 virus, hospitalized in Shohada Tajrish Hospital, affiliated with Shahid Beheshti University of medical sciences. We also discussed the presentation of patients, diagnostic and therapeutic approaches we have used, and patients' outcomes and compared our results with those from previous studies.…”