COVID-19-associated acute transverse myelitis: a rare entity

Area of Science:

• Neurology
• Infectious Diseases
• Critical Care Medicine

Background:

• Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes COVID-19, a disease primarily affecting the respiratory system.
• Extrapulmonary manifestations of COVID-19 are increasingly recognized, complicating patient care.
• Neurological complications, including myelopathy, are rare but serious potential sequelae of SARS-CoV-2 infection.

Observation:

• A 59-year-old female healthcare worker presented with acute-onset non-compressive myelopathy and fever.
• Neurological examination revealed a sensory level at the T10 segment.
• Dorsal spine MRI indicated myelitis at the T7 vertebral level.

Findings:

• The patient tested positive for SARS-CoV-2 via RT-PCR.
• Initial treatment with injectable steroids showed marginal improvement.
• The patient subsequently developed acute respiratory failure and could not be resuscitated.

Implications:

• This case highlights acute transverse myelitis as a potential, albeit rare, neurological complication of COVID-19.
• The findings underscore the importance of considering SARS-CoV-2 infection in patients presenting with acute myelopathy, especially in healthcare workers.
• Further research is warranted to elucidate the mechanisms linking SARS-CoV-2 to myelitis and to optimize management strategies for these neurological complications.