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Schulte, E.C. ; Hauer, L.* ; Kunz, A.B.* ; Sellner, J.*

Systematic review of cases of acute myelitis in individuals with COVID-19.

Eur. J. Neurol. 28, 3230-3244 (2021)
Postprint Research data DOI PMC
Open Access Gold (Paid Option)
BACKGROUND: 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: We performed a systematic review 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. PCR of CSF 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 (tested in 10 and 9 cases, respectively) antibodies in serum were negative. On MRI, 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 heterogenous. Whether the condition and the observed radiological characteristics are specific to SARS-CoV-2 infection needs to be clarified.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Covid-19 ; Sars-cov-2 ; Acute Transverse Myelitis ; Autoimmune ; Immune-mediated ; Neuroinfection ; Neurological Complication; Central-nervous-system; Transverse Myelitis; Coronavirus; Disorders; Child
ISSN (print) / ISBN 1351-5101
e-ISSN 1468-1331
Journal European Journal of Neurology
Quellenangaben Volume: 28, Issue: 10, Pages: 3230-3244 Article Number: , Supplement: ,
Publisher Wiley
Publishing Place 111 River St, Hoboken 07030-5774, Nj Usa
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Virology (VIRO)