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Forschungsdatenbank PMU-SQQUID

Systematic review of cases of acute myelitis in individuals with COVID-19.
Schulte, EC; Hauer, L; Kunz, AB; Sellner, J
Eur J Neurol. 2021; 28(10):3230-3244
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PMU-Autor/inn/en

Kunz Alexander
Sellner Larissa

Abstract

Background and purpose An incremental number of cases of acute transverse myelitis (ATM) in individuals with ongoing or recent coronavirus disease 2019 (COVID-19) have been reported. Methods A systematic review was performed of cases of ATM described in the context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by screening both articles published and in preprint. Results Twenty cases were identified. There was a slight male predominance (60.0%) and the median age was 56 years. Neurological symptoms first manifested after a mean of 10.3 days from the first onset of classical, mostly respiratory symptoms of COVID-19. Overall, COVID-19 severity was relatively mild. Polymerase chain reaction of cerebrospinal fluid for SARS-CoV-2 was negative in all 14 cases examined. Cerebrospinal fluid findings reflected an inflammatory process in most instances (77.8%). Aquaporin-4 and myelin oligodendrocyte protein antibodies in serum (tested in 10 and nine cases, respectively) were negative. On magnetic resonance imaging, the spinal cord lesions spanned a mean of 9.8 vertebral segments, necrotic-hemorrhagic transformation was present in three cases and two individuals had additional acute motor axonal neuropathy. More than half of the patients received a second immunotherapy regimen. Over a limited follow-up period of several weeks, 90% of individuals recovered either partially or near fully. Conclusion Although causality cannot readily be inferred, it is possible that cases of ATM occur para- or post-infectiously in COVID-19. All identified reports are anecdotal and case descriptions are heterogeneous. Whether the condition and the observed radiological characteristics are specific to SARS-CoV-2 infection needs to be clarified.


Useful keywords (using NLM MeSH Indexing)

COVID-19*

Guillain-Barre Syndrome*

Humans

Magnetic Resonance Imaging

Male

Middle Aged

Myelitis, Transverse*

SARS-CoV-2


Find related publications in this database (Keywords)

acute transverse myelitis
autoimmune
COVID-19
immune-mediated
neuroinfection
neurological complication
SARS-CoV-2