Medical School, University of Cyprus, Nicosia, Cyprus.
Department of Surgery, General Hospital of Agios Nikolaos, Agios Nikolaos, Greece.
Neurol Res. 2021 Aug;43(8):633-641. doi: 10.1080/01616412.2021.1915078. Epub 2021 Apr 17.
COVID-19 (CoranaVirus disease 2019) is an ongoing infectious disease caused by the RNA SARS-CoV-2 virus (Severe Acute Respiratory Syndrome CoronaVirus-2). More than one-third of COVID-19 patients report neurological symptoms and cases of neurological diseases are increasingly accumulating. The aim of this systematic review was to characterize all - to date - reported cases with COVID-19 related myelopathy. Eighteen papers were included in this review. Patients of all ages could be affected, although there is a predilection for middle-aged people. There were no significant co-morbidities or immunodeficiencies in the affected patients. COVID-19 related myelopathy started roughly within the first month after COVID-19 onset, either concomitantly with COVID-19 symptoms or within 10 days after their remission. The vast majority of cases fulfilled our criteria for postinfectious transverse myelitis. However, some cases were considered to have had parainfectious or infectious myelitis or, in one case, vascular myelopathy. Motor, sensory and bowel and/or bladder symptoms predominated the clinical presentation of myelopathies, explained mainly by centrally localized and longitudinally extensive lesions within the cervical and/or thoracic segments of the spinal cord. Occasionally lesions were complicated by necrosis and hemorrhages. Treatment with corticosteroids, intravenous immunoglobulin or plasma exchange was offered mostly a mild to marked improvement within a period of some weeks. Considering the imminent arrival of new vaccines against COVID-19 pandemic, and their potential risk for postvaccination transverse myelitis, this characterization of COVID-19 related myelopathy is of utmost importance.
新型冠状病毒病（COVID-19）是一种由 RNA SARS-CoV-2 病毒（严重急性呼吸系统综合症冠状病毒 2 型）引起的正在流行的传染病。超过三分之一的 COVID-19 患者报告有神经系统症状，并且神经系统疾病的病例正在逐渐增加。本系统综述的目的是描述迄今为止所有与 COVID-19 相关的脊髓病病例。本综述纳入了 18 篇论文。所有年龄段的患者都可能受到影响，尽管中年人更为易感。受影响的患者没有明显的合并症或免疫缺陷。COVID-19 相关的脊髓病在 COVID-19 发病后大约一个月内开始出现，要么与 COVID-19 症状同时发生，要么在其缓解后 10 天内出现。绝大多数病例符合我们的感染后横贯性脊髓炎标准。然而，有些病例被认为是副感染性或感染性脊髓炎，还有一例是血管性脊髓病。运动、感觉和肠/膀胱症状是脊髓病的主要临床表现，这主要是由于颈段和/或胸段脊髓的中央性和长节段性病变所致。偶尔病变伴有坏死和出血。皮质类固醇、静脉注射免疫球蛋白或血浆置换治疗主要在数周内使病情有轻度到明显改善。考虑到针对 COVID-19 大流行的新疫苗即将问世，以及它们在接种疫苗后发生横贯性脊髓炎的潜在风险，对 COVID-19 相关脊髓病的这种特征描述是至关重要的。
