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COVID-19 and spinal cord injury: clinical presentation, clinical course, and clinical outcomes of people hospitalised

Spinal Cord Series and Cases volume 10, Article number: 5 (2024) Cite this article

Subjects

Abstract

Study design

Retrospective study

Objectives

To describe the presenting symptoms/signs, clinical course and outcomes in hospitalised people with spinal cord injury (SCI) and symptomatic COVID-19 infections.

Setting

One university hospital and two SCI centres in Switzerland.

Methods

Descriptive analysis of symptoms/signs, clinical course and outcomes of people with SCI with symptomatic COVID-19 infections and need for hospitalisation.

Results

Twenty-two people with SCI were included, 15 (68%) were male, median age 64.5 years (interquartile range, IQR, 52–73 years). Nine (41%) had tetraplegia, and eight (36%) were classified with motor-complete lesions. Frequent clinical symptoms were fever (59%), coughing (54%), fatigue (50%), and dyspnoea (27%). Most frequent complications were bacterial pulmonary superinfection (18%), and acute respiratory distress syndrome (18%). Fifteen persons (68%) needed oxygen therapy during the course of hospitalisation, and 7 (32%) people were ventilated. Median length of stay (LOS) was 23 days (IQR 15–35), varying by age for people under 60 years with a median LOS of 9 days (IQR 8–27), and for those older than 60 years with a median of 34 days (IQR 17–39), respectively. In total, 3 persons (14%) died during hospitalisation, all older with paraplegia.

Conclusions

Typical symptoms like fever and coughing were not present in all people. People with tetraplegia did not demonstrate worse outcomes, on the contrary, they had shorter LOS, no difference in ventilation needs, and no higher mortality compared to people with paraplegia. Older people showed longer LOS. This study recommends close supervision of the SCI population to detect early signs and symptoms of COVID-19 infection.

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Fig. 1: Thorax X-ray finding of a COVID-19 infected person.
Fig. 2: Computer tompgraphy (CT) chest finding of a COVID-19 infected person.

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Data availability

All data supporting the findings of this study are available within the article and its Supplementary Materials

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Author information

Authors and Affiliations

  1. Swiss Paraplegic Centre, Nottwil, Switzerland

    Inge E. Eriks-Hoogland, Michael A. Barth & Jürgen Pannek

  2. Faculty of Health Sciences and Medicine at the University of Lucerne, Lucerne, Switzerland

    Inge E. Eriks-Hoogland

  3. Swiss Paraplegic Research, Nottwil, Switzerland

    Inge E. Eriks-Hoogland & Lorena L. Müller

  4. Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    Dominique Braun

  5. Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland

    Armin Curt

  6. John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia

    Mohit Arora & James W. Middleton

  7. The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia

    Mohit Arora & James W. Middleton

  8. Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

    Jürgen Pannek

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  1. Inge E. Eriks-Hoogland
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Contributions

IEH proposed the study, and MB, LM, and IEH accomplished its design, conceptualisation and implementation. Study data were collected by MB and LM. Statistical analysis was performed by LM and MB. LM, MB and IEH examined and interpreted the data. The manuscript was drafted by MB with support of LM, and IEH. All authors provided critical feedback on the manuscript regarding important intellectual content, and provided their approval on the final version.

Corresponding author

Correspondence to Inge E. Eriks-Hoogland.

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Competing interests

The authors declare no competing interests.

Ethics approval

The study was formally approved by regional medical ethics committee of northwest and central Switzerland (Project-ID 2021-01904). All the participants included in the study consented to anonymized use of data for research purposes and had the option to opt out.

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Eriks-Hoogland, I.E., Barth, M.A., Müller, L.L. et al. COVID-19 and spinal cord injury: clinical presentation, clinical course, and clinical outcomes of people hospitalised. Spinal Cord Ser Cases 10, 5 (2024). https://doi.org/10.1038/s41394-024-00617-6

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  • DOI: https://doi.org/10.1038/s41394-024-00617-6

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