Complications of Spinal Cord Injury can Hide Fever and Cough Associated to COVID-19

Main Article Content

Aylin Ayyıldız
Banu Kuran
Banu Altoparlak
Beril Dogu
Figen Yılmaz

Abstract

Aim: Coronavirus disease (COVID-19) is a lower respiratory tract infectious disease. This new coronavirus responsible for severe acute respiratory syndrome, higher level of illness and death. Comorbid health conditions are highly important in clinical course of Coronavirus disease. Patient with spinal cord injury (SCI) may have numerous comorbidities like respiratory muscle weakness, tendency to coagulation caused by immobilisation, autonomic dysreflexia accompanied by hypertension, urinary tract infection, SCI-induced immune suppression etc.

Case of Presentation: A 43 year-old male patient is affected by ASIA A, T7 level paraplegia. After the COVID-19 outbreak, he acquired severe dorsal pain with recurrent submaximal fever at night. The patient was considered primarily as a urinary tract infection. He was evaluated covid-19 on the development of dyspnoea and cough in the following periods. Due to SCI complications, it is late in diagnosis and treatment.

Discussion: SCI patients are vulnerable individuals of our society in having respiratory infections. Comorbidities caused by the spinal cord injury lay the ground for this. The importance of this sensitive condition should be emphasized in the COVID-19 pandemic. SCI patients may not come with symptoms such as fever, cough and dyspnoea, which are typical symptoms of covid-19 in initial hospital admissions.

Conclusion: Complications of SCI can cover COVID-19 infections. Evaluating SCI patients in terms of infection, this should be known and cautious. In this way, there is no delay in the treatment of SCI patients and less mortality can be observed.

Keywords:
Coronavirus, infections, spinal cord injuries

Article Details

How to Cite
Ayyıldız, A., Kuran, B., Altoparlak, B., Dogu, B., & Yılmaz, F. (2020). Complications of Spinal Cord Injury can Hide Fever and Cough Associated to COVID-19. Asian Journal of Case Reports in Medicine and Health, 3(3), 1-5. Retrieved from https://journalajcrmh.com/index.php/AJCRMH/article/view/30128
Section
Case Report

References

Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. New England Journal of Medicine. 2020;382:1199-207.

Coronavirus COVID-19 Global Cases by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). JHU COVID-19 Resource Center. Johns Hopkins Coronavirus Resource Center.

Available:https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

(Accessed 20 May 2020)

The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41:145-51.

McDonald JW, Sadowsky C. Spinal-cord injury. Lancet. 2002;359:417-25.

Trbovich M, Li C, Lee S. Does the CDC definition of fever accurately predict inflammation and infection in persons with SCI? Top Spinal Cord Inj Rehabil. 2016;22:260-8.

Dicks MA, Clements ND, Gibbons CR, Verduzco-Gutierrez M, Trbovich M. Atypical presentation of Covid-19 in persons with spinal cord injury. Spinal Cord Series and Cases. 2020;6:38.

Cardozo CP. Respiratory complications of spinal cord injury. J Spinal Cord Med. 2007;30:307-8.

Rodríguez-Cola M, Jiménez-Velasco I, Gutiérrez-Henares F, et al. Clinical features of coronavirus disease 2019 (COVID-19) in a cohort of patients with disability due to spinal cord injury. Spinal Cord Ser Cases. 2020;6:39.

Korupolu R, Stampas A, Gibbons C, Hernandez Jimenez I, Skelton F, Verduzco-Gutierrez M. COVID-19: Screening and triage challenges in people with disability due to spinal cord injury. Spinal Cord Series and Cases. 2020;6: 35.

Held KS, Steward O, Blanc C, Lane TE. Impaired immune responses following spinal cord injury lead to reduced ability to control viral infection. Exp Neurol. 2010;226:242-53.

Schmidt KD, Chan CW. Thermoregulation and fever in normal persons and in those with spinal cord injuries. Mayo Clin Proc. 1992;67:469-75.