Righi Gabriele, Del Popolo Giulio
Spinal Unit, Careggi University Hospital, Firenze, Italy.
Spinal Cord Ser Cases. 2020 Apr 17;6(1):22. doi: 10.1038/s41394-020-0274-9.
We present the report of the first, to our best knowledge, case of COVID-19 in a tetraplegic person.
A 56-year-old male with AIS A C4 tetraplegia developed fever during the night, without any prodrome. His general practitioner suspected a urinary tract infection and prescribed him antibiotic therapy. After 2 days of antibiotic therapy the fever still persisted, so the individual was admitted to the local hospital and treated with broad-spectrum antibiotics. After 2 days he was transferred to our spinal unit. Considering the worsening of the chest X-ray and fever despite 48 h of broad-spectrum antibiotic therapy, we strongly suspected viral pneumonia. SARS-CoV-2 was detected and antiviral therapy with Lopinavir/Ritonavir, associated with hydroxychloroquine, was promptly started. Fever ceased after 2 days of therapy.
Blood test and chest X-ray findings in this patient were similar to previously published findings regarding COVID-19. One difference between this case and the known clinical course of COVID-19 is that did not develop cough. Another interesting feature of our case is that, despite tetraplegia, the clinical course was not severe. Persons with COVID-19 remain asymptomatic, these results underscore the need for rehabilitation and SCI professionals to have a high index of suspicion for COVID-19 in their inpatient and outpatient clients. Only inpatient with fever hase being tested for COVID-19. All new patients are submitted to SARS-COV-2 Test. Moreover, routine testing of patients who have to participate in therapy in common gym areas may be warranted.
据我们所知，我们报告首例四肢瘫痪患者的新型冠状病毒肺炎病例。
一名56岁男性，患有美国脊髓损伤协会（AIS）A级C4四肢瘫痪，夜间发热，无任何前驱症状。他的全科医生怀疑是尿路感染，并给他开了抗生素治疗。抗生素治疗2天后，发热仍持续，因此该患者被收治到当地医院，接受广谱抗生素治疗。2天后，他被转到我们的脊髓病房。尽管进行了48小时的广谱抗生素治疗，但胸部X光检查结果恶化且仍发热，我们强烈怀疑是病毒性肺炎。检测出新型冠状病毒2（SARS-CoV-2），并立即开始使用洛匹那韦/利托那韦联合羟氯喹进行抗病毒治疗。治疗2天后发热停止。
该患者的血液检查和胸部X光检查结果与先前发表的关于新型冠状病毒肺炎的结果相似。该病例与已知的新型冠状病毒肺炎临床病程的一个不同之处在于没有出现咳嗽。我们病例的另一个有趣特征是，尽管是四肢瘫痪，但临床病程并不严重。新型冠状病毒肺炎患者可能无症状，这些结果强调康复和脊髓损伤专业人员需要对住院和门诊患者的新型冠状病毒肺炎有高度的怀疑指数。只有发热的住院患者接受了新型冠状病毒肺炎检测。所有新患者都接受了新型冠状病毒2（SARS-CoV-2）检测。此外，对于必须在公共健身房区域参与治疗的患者，可能有必要进行常规检测。
