SA doctor experiences rare spinal paralysis from COVID-19

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Initially, COVID-19 had not made him that ill. News24 reports that on one day, he struggled with a nasal drip, a sore throat on another day, lost his sense of smell for three days and then experienced a loss of taste for two days. But when he suddenly, within 30 seconds, could no longer walk, he realised something was seriously wrong, Dr Waltie Vermeulen, 63, a general practitioner in Hopetown in the Northern Cape, is quoted in the report as saying.

According to neurologists who examined him, this is probably the second recorded case in the world where temporary spinal cord paralysis developed as a complication of COVID-19, he said.

News24 reports, however, that it found that at least three other cases have been recorded for the rare symptom.

A 60-year-old German man suffered from acute transverse myelitis after being admitted to the Medical Centre Esslingen, Academic Teaching Hospital of the University of Tübingen, for COVID-19 pneumonia, researchers said. It also affected his bladder. He was able to walk again independently after 13 days and his bladder function returned to normal.

A 66-year-old patient in China also had acute myelitis, according to researchers at the Renmin Hospital of Wuhan University, and a 28-year-old in the US, according to this case report from the University of California – Irvine.

Vermeulen is being taken care of by a neurologist, infection control specialist and internist in Bloemfontein, the report says.

Abstract 1
Neurological complications of SARS-CoV2 infection are increasingly recognized. Recently, a SARS-CoV2 induced focal encephalitis was reported. Here we describe a case of multifocal transverse myelitis following acute COVID-19 pneumonia.

Authors
Maike Munz, Swen Wessendorf, Georgios Koretsis, Friedemann Tewald, Reem Baegi, Stefan Krämer, Michael Geissler, Matthias Reinhard

Abstract 2
We firstly reported a case of acute myelitis in a SARS-CoV-2-infected patient. A 66-year-old man with COVID-19 was admitted with acute flaccid paralysis of bilateral lower limbs and urinary and bowel incontinence. All serum microbiological studies were negative except for SARS-CoV-2 nucleic acid testing. Clinical findings could be ascribed to a post-infectious acute myelitis. He was receiving treatment with ganciclovir, lopinavir/ritonavir, moxifloxacin, dexamethasone, human immunoglobulin and mecobalamin. With a diagnosis of post-infectious acute myelitis and comprehensive treatment, paralysis of bilateral lower extremities ameliorated. After two times negative novel coronavirus RNA nasopharyngeal swabs tests, he was discharged and transferred to a designated hospital for isolation treatment and rehabilitation therapy.

Authors
Kang Zhao, Jucun Huang, Dan Dai, Yuwei Feng, Liming Liu, Shuke Nie

Abstract 3
Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, emergency providers are not only seeing an increasing number of patients with COVID-19 infections, but also associated complications and sequelae of this viral illness.
Case Report: We present the case of a 28-year-old female patient who presented after a confirmed COVID-19 infection with lower back pain, bilateral symmetric upper and lower extremity numbness, and urinary retention. The patient was diagnosed with acute transverse myelitis. She required intravenous corticosteroids and plasma exchange with significant improvement in symptoms and minimal residual effects.
Conclusion: This case illustrates the importance of prompt recognition and treatment of sequelae of COVID-19 infections.

Authors
Sarma, Deesha; Bilello, Leslie A

Full News24 report

 

Journal of Neurology abstract

 

MedRxiv abstract

 

eScholarship abstract

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