Two Case Reports of Patients With Transverse Myelitis as a Complication of SARS-CoV-2 Infection

Cureus, 2022 · DOI: 10.7759/cureus.29191 · Published: September 15, 2022

Simple Explanation

Transverse myelitis (TM) is a rare condition causing spinal cord injury, leading to weakness and sensory issues. This report discusses two cases where elderly men developed TM following SARS-CoV-2 infection, even without typical COVID-19 symptoms. Both patients were treated with steroids and plasmapheresis, experiencing some improvement. The study highlights the potential for rare complications like TM from COVID-19 and the importance of tailored treatment. The patients, unvaccinated against SARS-CoV-2, experienced lower extremity deficits, sensory loss, and urinary retention. They responded positively to intravenous steroids and plasmapheresis, showcasing the importance of recognizing and treating such atypical presentations of COVID-19.

Study Duration

Not specified

Participants

Two elderly male patients

Evidence Level

Case Reports

Key Findings

1
Both patients developed acute TM following SARS-CoV-2 infection, despite only exhibiting mild or no classic COVID-19 symptoms.
2
Treatment with intravenous steroids provided minimal improvement, but therapeutic plasmapheresis led to significant gains in muscular strength and ASIA grade improvement.
3
MRI findings correlated with TM, showing diffuse central T2 lengthening in one case and a long segment of high signal in the spinal cord in the other, indicating longitudinally extensive TM.

Research Summary

This article presents two case reports of elderly male patients who developed transverse myelitis (TM) as a complication of SARS-CoV-2 infection. Both patients experienced lower extremity weakness, sensory loss, and urinary retention but had only mild or absent classic COVID-19 symptoms. The patients were treated with intravenous steroids and therapeutic plasmapheresis (TPE). While steroid treatment showed limited effectiveness, TPE resulted in significant improvements in muscular strength and neurological function, as indicated by the ASIA grade. The study highlights the importance of recognizing TM as a potential neurological complication of SARS-CoV-2 infection, even in the absence of typical respiratory symptoms. It also suggests that TPE can be an effective treatment option for patients with TM secondary to SARS-CoV-2, particularly when steroids are insufficient.

Practical Implications

Early Diagnosis

Recognize TM as a possible atypical presentation of SARS-CoV-2 infection, even without typical symptoms.

Treatment Strategy

Consider therapeutic plasmapheresis (TPE) for SARS-CoV-2-associated TM, especially when initial steroid treatment yields limited improvement.

Rehabilitation Importance

Emphasize comprehensive rehabilitation, including physical and occupational therapy, along with bladder and bowel management, for TM patients to improve functional outcomes and independence.

Two Case Reports of Patients With Transverse Myelitis as a Complication of SARS-CoV-2 Infection

Simple Explanation

Key Findings

Research Summary

Practical Implications

Early Diagnosis

Treatment Strategy

Rehabilitation Importance

Study Limitations

Your Feedback

Was this summary helpful?

Two Case Reports of Patients With Transverse Myelitis as a Complication of SARS-CoV-2 Infection

Simple Explanation

Key Findings

Research Summary

Practical Implications

Early Diagnosis

Treatment Strategy

Rehabilitation Importance

Study Limitations

Your Feedback

Was this summary helpful?