Rodríguez-Cola Miguel, Jiménez-Velasco Irena, Gutiérrez-Henares Francisco, López-Dolado Elisa, Gambarrutta-Malfatti Claudia, Vargas-Baquero Eduardo, Gil-Agudo Ángel
Department of Internal Medicine, Hospital Nacional de Parapléjicos de Toledo, Toledo, Spain.
Department of Rehabilitation, Hospital Nacional de Parapléjicos de Toledo, Toledo, Spain.
Spinal Cord Ser Cases. 2020 May 13;6(1):39. doi: 10.1038/s41394-020-0288-3.
Cohort study of patients with spinal cord injury (SCI).
To describe the clinical and analytical features of a coronavirus disease 2019 (Covid-19) infected cohort with SCI to enable accurate diagnosis and to outline prevention measures.
This study was conducted at the National Hospital for Paraplegics (Toledo, Spain).
A cohort analysis of seven patients with SCI infected by Covid-19 was performed. Diagnosis was confirmed with reverse transcriptase polymerase chain reaction (RT-PCR) of nasal exudate or sputum samples. Clinical, analytical, and radiographic findings were registered.
RT-PCR detected COVID-19 infection in all patients, affecting males and people with a cervical level of injury more often (five out of seven). The average delay for diagnostic confirmation was 4 days (interquartile range, 1-10). Fever was the most frequent symptom (six out of seven). The second most common symptom was asthenia (four out of seven), followed by dyspnea, cough, and expectoration (three out of seven for each symptom). The Modified Early Warning System score for Covid-19 severity rating was classified as severe in five out of seven cases. All but one patient showed radiological alterations evident in chest X-rays at the time of diagnosis. All patients recovered gradually.
Our patients with SCI and Covid-19 infection exhibited fewer symptoms than the general population. Furthermore, they presented similar or greater clinical severity. The clinical evolution was not as pronounced as had been expected. This study recommends close supervision of the SCI population to detect early compatible signs and symptoms of Covid-19 infection.
对脊髓损伤（SCI）患者的队列研究。
描述2019冠状病毒病（Covid-19）感染的脊髓损伤队列的临床和分析特征，以实现准确诊断并概述预防措施。
本研究在西班牙托莱多的国家截瘫医院进行。
对7例感染Covid-19的脊髓损伤患者进行队列分析。通过鼻分泌物或痰液样本的逆转录聚合酶链反应（RT-PCR）确诊。记录临床、分析和影像学检查结果。
RT-PCR在所有患者中均检测到Covid-19感染，男性和颈髓损伤患者更常受影响（7例中有5例）。确诊的平均延迟时间为4天（四分位间距，1-10天）。发热是最常见的症状（7例中有6例）。第二常见症状是乏力（7例中有4例），其次是呼吸困难、咳嗽和咳痰（每种症状7例中有3例）。7例中有5例的Covid-19严重程度分级的改良早期预警系统评分被归类为严重。除1例患者外，所有患者在诊断时胸部X线均显示明显的影像学改变。所有患者均逐渐康复。
我们的脊髓损伤合并Covid-19感染患者的症状比普通人群少。此外，他们表现出相似或更高的临床严重程度。临床病程不如预期明显。本研究建议对脊髓损伤人群进行密切监测，以早期发现Covid-19感染的相关体征和症状。
