Acute Spinal Cord Dysfunction Following COVID-19 Infection: A Case Report

Abstract

Here, we describe a 44-year-old female that developed abrupt symptomatology, including lower-limb paralysis with sensory involvement at the T12 level, two weeks after the resolution of COVID-19 bilateral pneumonia. Based on the neurological symptoms and the neurophysiological investigations, a clinical diagnosis of thoracic spinal cord dysfunction was made. However, all the complementary tests performed showed normal results. In particular, repeated MRIs showed no alterations; the cerebrospinal fluid analysis showed normal results: the CT scan of the brain was normal and the CT scan of the abdominal and thoracic aorta showed a normal size and course. Cases of spinal cord involvement have rarely been described, in which the MRIs never revealed cord signaling changes. We hypothesize that a small vessel spinal cord stroke might explain the pathogenesis and the absence of changes detectable on an MRI along with the patient's modest recovery during the long follow up. However, it cannot be excluded that the severe clinical course of SARS-CoV-2 infection, may suggest other different etiologies that could be related to prolonged hospitalization.