PMID- 33845350 OWN - NLM STAT- MEDLINE DCOM- 20210707 LR - 20221222 IS - 2211-0356 (Electronic) IS - 2211-0348 (Print) IS - 2211-0348 (Linking) VI - 51 DP - 2021 Jun TI - COVID-19 and emerging spinal cord complications: A systematic review. PG - 102917 LID - S2211-0348(21)00184-X [pii] LID - 10.1016/j.msard.2021.102917 [doi] AB - BACKGROUND: Spinal cord complications associated with coronavirus infectious disease of 2019 (COVID-19) are being widely reported. The purpose of this systematic review was to summarize so far available pieces of evidence documenting de novo novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) mediated spinal cord demyelinating diseases. Indeed, the spinal demyelinating disorders that have been reported in those patients who have suffered from COVID-19 rather than on the people already living with diagnosed or undiagnosed primary demyelinating disorders. METHODS: We used the existing PRISMA consensus statement. Data were collected from PubMed, NIH Litcovid, EMBASE and Cochrane library databases, as well as Pre-print servers (medRxiv, bioRxiv, and pre-preints.org), until September 10, 2020, using pre-specified searching strategies. RESULTS: The 21 selected articles were all case reports and included 11 (52%) men and 10 (48%) women. The mean age was of 46.7 +/- 18.0. The neurological manifestations included weakness, sensory deficit, autonomic dysfunction and ataxia. In most cases, elevated cerebrospinal fluid protein as well as lymphocytic pleocytosis were found. SARS-CoV-2 was detected in five (24%) patients, meanwhile in 13 (62%) patients, the testing was negative. Testing was not performed in two cases and, in one, data were unavailable. Nearly half of the cases (N = 9) were associated with isolated long extensive transverse myelitis (LETM), whereas a combination of both LETM and patchy involvement was found in two. Only five patients had isolated short segment involvement and two patchy involvement. Furthermore, concomitant demyelination of both brain and spine was reported in six patients. Concerning the prognosis, most of the patients improved and the mortality rate was low (N = 2, <10%). CONCLUSION: Spinal cord demyelination should be added to the plethora of immune mediated neurologic complications associated with COVID-19. CI - Copyright (c) 2021 Elsevier B.V. All rights reserved. FAU - Mondal, Ritwick AU - Mondal R AD - Institute of Post Graduate Medical Education and Research, SSKM Hospital, Kolkata, India. FAU - Deb, Shramana AU - Deb S AD - S.N. Pradhan Centre for Neuroscience, University of Calcutta, Kolkata, India. FAU - Shome, Gourav AU - Shome G AD - Department of Microbiology, University of Calcutta, Kolkata, India. FAU - Ganguly, Upasana AU - Ganguly U AD - Institute of Post Graduate Medical Education and Research, SSKM Hospital, Kolkata, India. FAU - Lahiri, Durjoy AU - Lahiri D AD - Institute of Post Graduate Medical Education and Research, SSKM Hospital, Kolkata, India; R.G. Kar Medical College and Hospital, Kolkata, India. Electronic address: dlahiri1988@gmail.com. FAU - Benito-Leon, Julian AU - Benito-Leon J AD - Department of Neurology, University Hospital "12 de Octubre",Madrid, Spain; Centro de Investigacion Biomedica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Department of Medicine, Complutense University, Madrid, Spain. Electronic address: jbenitol67@gmail.com. LA - eng GR - R01 NS039422/NS/NINDS NIH HHS/United States PT - Journal Article PT - Systematic Review DEP - 20210321 PL - Netherlands TA - Mult Scler Relat Disord JT - Multiple sclerosis and related disorders JID - 101580247 SB - IM MH - *COVID-19 MH - *Communicable Diseases MH - Female MH - Humans MH - Male MH - *Nervous System Diseases MH - SARS-CoV-2 MH - Spinal Cord PMC - PMC7981271 OTO - NOTNLM OT - Coronavirus OT - Covid-19 OT - Demyelinating disorders OT - Encephalomyelitis OT - Multiple sclerosis OT - Sars-cov-2 COIS- Declaration of Competing Interest We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us. We confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication, including the timing of publication, with respect to intellectual property. In so doing we confirm that we have followed the regulations of our institutions concerning intellectual property. We further confirm that any aspect of the work covered in this manuscript that has involved either experimental animals or human patients has been conducted with the ethical approval of all relevant bodies and that such approvals are acknowledged within the manuscript. EDAT- 2021/04/13 06:00 MHDA- 2021/07/08 06:00 PMCR- 2021/03/21 CRDT- 2021/04/12 20:22 PHST- 2020/10/07 00:00 [received] PHST- 2021/01/18 00:00 [revised] PHST- 2021/03/17 00:00 [accepted] PHST- 2021/04/13 06:00 [pubmed] PHST- 2021/07/08 06:00 [medline] PHST- 2021/04/12 20:22 [entrez] PHST- 2021/03/21 00:00 [pmc-release] AID - S2211-0348(21)00184-X [pii] AID - 102917 [pii] AID - 10.1016/j.msard.2021.102917 [doi] PST - ppublish SO - Mult Scler Relat Disord. 2021 Jun;51:102917. doi: 10.1016/j.msard.2021.102917. Epub 2021 Mar 21.