Clinical features and prognosis of COVID-19 in people with spinal cord injury: a case-control study

Spinal Cord Ser Cases. 2020 Aug 4;6(1):69. doi: 10.1038/s41394-020-0319-0.

Abstract

Study design: Observational case-control study.

Objective: Individuals with spinal cord injury (SCI) develop systemic physiological changes that could increase the risk of severe evolution of coronavirus disease 2019 (COVID-19) and result in atypical clinical features of COVID-19 with possible delay in both diagnosis and treatment. We evaluated differences in clinical features and evolution of COVID-19 between people with SCI and able-bodied individuals.

Setting: The study was conducted in an Italian inpatient rehabilitation referral center for individuals with SCI during the lockdown for the COVID-19 pandemic.

Methods: We compared clinical information between patients with SCI and able-bodied healthcare workers of the same center who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the nasopharyngeal swab polymerase chain reaction.

Results: Overall, 15 out of the 25 SCI patients admitted to the center and 17 out of the 69 healthcare workers tested positive for SARS-CoV-2. Patients with SCI exhibited a significantly more advanced age and a higher prevalence of comorbidities. Nevertheless, no significant differences in clinical expression of COVID-19 and treatment strategies were observed between the two groups. All hospitalized subjects were treated in nonintensive care units and no deaths occurred in either group.

Conclusions: This study does not support the supposed notion that COVID-19 could exhibit atypical clinical features or a worse evolution in the frail population of people with SCI.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Anticoagulants / therapeutic use*
  • Antiviral Agents / therapeutic use*
  • Azithromycin / therapeutic use
  • Betacoronavirus
  • COVID-19
  • COVID-19 Drug Treatment
  • Case-Control Studies
  • Coronavirus Infections / complications
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / physiopathology
  • Coronavirus Infections / therapy*
  • Drug Combinations
  • Enzyme Inhibitors / therapeutic use
  • Female
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Hydroxychloroquine / therapeutic use*
  • Italy
  • Lopinavir / therapeutic use
  • Male
  • Middle Aged
  • Oxygen Inhalation Therapy*
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / physiopathology
  • Pneumonia, Viral / therapy*
  • Prognosis
  • Rehabilitation Centers
  • Ritonavir / therapeutic use
  • SARS-CoV-2
  • Spinal Cord Injuries / complications
  • Spinal Cord Injuries / physiopathology*

Substances

  • Anti-Bacterial Agents
  • Antibodies, Monoclonal, Humanized
  • Anticoagulants
  • Antiviral Agents
  • Drug Combinations
  • Enzyme Inhibitors
  • Heparin, Low-Molecular-Weight
  • lopinavir-ritonavir drug combination
  • Lopinavir
  • Hydroxychloroquine
  • Azithromycin
  • tocilizumab
  • Ritonavir