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Journal of Rehabilitation Research and Practice

ISSN: 2694-0388

Case Series Open Access
Volume 4 | Issue 1 | DOI: https://doi.org/10.46439/rehabilitation.4.021

Spinal cord infarction associated with severe acute respiratory syndrome coronavirus 2: A case series of diagnostic challenges and postacute sequelae of COVID-19

Christina V. Oleson1,*, Suzanna Shermon1, Andrew C. Olsen1
  • 1Department of Physical Medicine and Rehabilitation, Case Western Reserve University, MetroHealth Rehabilitation Institute, The MetroHealth System, Cleveland, Ohio, USA
+ Affiliations - Affiliations

Corresponding Author

Christina V. Oleson, coleson@metrohealth.org

Received Date: September 25, 2023

Accepted Date: October 19, 2023

Citation:

Oleson CV, Shermon S, Olsen AC. Spinal cord infarction associated with severe acute respiratory syndrome coronavirus 2: A case series of diagnostic challenges and post-acute sequelae of COVID-19. J Rehabil Res Pract. 2023;4(1):13-21.


Copyright: © 2023 Oleson CV, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction: Stroke and lower extremity venous thromboemboli have been commonly reported following acute infection with severe acute respiratory syndrome of coronavirus-19 (SARS-CoV-2), but spinal cord infarction or ischemia is far less frequent. When diagnosis of either COVID-19 or its neurovascular complications are delayed, functional outcomes may be compromised. 
Case presentations: We present 2 middle-aged, Caucasian females with sudden onset of non-traumatic spinal cord injury (NTSCI) due to spinal cord infarction or ischemia attributed to acute infection with SARS-CoV-2. Both demonstrated lower extremity weakness with absent pinprick, but eventually recovered limited ambulation with equipment and bracing. Their reports of myalgias, neuropathic pain, muscle spasticity, and urinary tract complications, including hematuria and infections, exceeded the frequency and severity of other SCI individuals of similar age and degree of neurological impairment. One individual experienced a delay in diagnosis of COVID-19 and the other, a delay in identifying the spinal cord infarction. Both had protracted rehabilitation courses and have since developed post-acute sequelae of SARS-CoV-2 (PASC).
Discussion: Vascular injuries in the form of spinal cord infarction can occur due to SARS-CoV-2, with resultant moderate to severe sensory and motor impairment and long-term disability. Symptoms such as myalgias, neuropathic pain, muscle spasms, and frequent bacterial infections are a part of PASC, independent of any spinal cord injury. The dual presence of PASC and recent SCI attributed to COVID-19 may lead to increased severity of symptoms shared by both conditions, only heightening the need for early rehabilitation.

Keywords

COVID-19, Long COVID, Spinal cord infarction, Non-traumatic spinal cord injury, SARSCoV-2, Rehabilitation, Quality of life

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