Острый миелит, ассоциированный с COVID-19

Abstract

Objective of the Review: To summarise the data of academic publications dedicated to myelitis as a COVID-19 complication in order to improve its early diagnosis and management in neurology. Key Points. International databases have 18 cases of COVID-19-associated acute myelitis described. COVID-19-associated myelitis should be suspected when a patient with clinical manifestations of this infection or 1-2 weeks after its regression has increasing leg weakness or tetraparesis, sensation disorders and pelvic dysfunction for several days. To prove the diagnosis and exclude other causes of spinal cord damages, it is essential to perform spinal magnetic resonance imaging, spinal fluid tests, and blood examinations. The pathogenesis of COVID-19-associated myelitis is primarily a result of hyperreactive system inflammatory response and a secondary autoimmune-mediated spinal cord damage; however, direct virus infiltration of the central nervous system is also possible. Timely therapy of myelitis using glucocorticosteroids, plasma exchange and/or intravenous administration of human immunoglobulin can lead to partial or complete regression of neurological disorders. Conclusion. Myelitis is a rare, still serious COVID-19 complication, since is causes severe neurologic impairment and marked physical dysfunctions. Early diagnosis of this condition is vital, since it helps in timely initiation of therapy. Keywords: acute myelitis, coronavirus disease 2019, COVID-19, SARS-CoV-2.