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Management of Spinal Cord Injury During COVID-19 Era

  • Azharuddin Azharuddin ,
  • Diaz Novera ,

Abstract

Coronavirus disease (COVID-19) was declared a pandemic in March 2020 and has the potential to overload health system, compromise hospital staffs and use up essential hospital supplies. Patients with Spinal Cord Injuries (SCI) are classified as patient with disability and has increased morbidity from COVID-19 due to physiological changes from the nature of pathology, subsequently their clinical and social characteristics puts them in high risk of contracting COVID-19. Patients with SCI might present different symptoms of COVID-19 than others. Weakness in thoraco-abdominal and diaphragm muscles might impair cough, reduce lung volumes, and reduce flow rates. Interrupted pathway between hypothalamus and efferent nerves (sympathetic and motoric) might results in temperature dysregulation (poikilothermia) and dysfunction of febrile response. Patients with injuries at higher levels would present with more severe symptoms. The pandemic of COVID-19 further complex the situation of delivering adequate and dignified treatment. Therefore, the main goal is for complete avoidance of infection in this specific population and should be considered with high index of suspicion when mild symptoms of COVID-19 are present. This vulnerable group of patients deserves more attention when presented with extraordinary situations such as pandemics or earthquakes. This overview summarizes the symptom and pathophysiology of SCI in COVID-19 pandemic. 

References

  1. Palipana D. COVID-19 and spinal cord injuries: The viewpoint from an emergency department resident with quadriplegia. Emerg Med Australas. 2020. https://doi.org/10.1111/1742-6723.13525
  2. Boldrini P, Garcea M, Brichetto G, Reale N, Tonolo S, Falabella V, et al. Living with a disability during the pandemic. ‘‘Instant paper from the field’’ on rehabilitation answers to the COVID-19 emergency. Eur J Phys Rehabil Med. 2020. https://doi.org/10.23736/S1973-9087.20.06373-X
  3. 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. Version 2. Spinal Cord Ser Cases. 2020;6(1):35. https://doi.org/10.1038/s41394-020-0284-7
  4. Cardozo CP. Respiratory complications of spinal cord injury. J Spinal Cord Med. 2007;30(4):307-8. https://doi.org/10.1080/10790268.2007.11753945
  5. Biering-Sørensen F, Biering-Sørensen T, Liu N, Malmqvist L, Wecht JM, Krassioukov A. Alterations in cardiac autonomic control in spinal cord injury. Auton Neurosci. 2018;209:4-18. https://doi.org/10.1016/j.autneu. 2017.02.004
  6. Pru?ss H, Tedeschi A, Thiriot A, Lynch L, Loughhead SM, Stutte S, et al. Spinal cord injury-induced immunodeficiency is mediated by a sympa- thetic-neuroendocrine adrenal reflex. Nat Neurosci. 2017;20(11):1549-59. https://doi.org/10.1038/nn.4643
  7. Lavela SL, Weaver FM, Goldstein B, Chen K, Miskevics S, Rajan S, et al. Diabetes mellitus in individuals with spinal cord injury or disorder. J Spinal Cord Med. 2006;29(4):387-95. https://doi.org/10.1080/10790268. 2006.11753887
  8. Dicks MA, Clements ND, Gibbons CR, Verduzco-Gutierrez M, Trbovich M. Atypical presentation of Covid-19 in persons with spinal cord injury. Version 2. Spinal Cord Ser Cases. 2020;6(1):38. https://doi.org/10.1038/ s41394-020-0289-2
  9. Rodri?guez-Cola M, Jime?nez-Velasco I, Gutie?rrez-Henares F, Lo?pez- Dolado E, Gambarrutta-Malfatti C, Vargas-Baquero E, et al. Clinical fea- tures of coronavirus disease 2019 (COVID-19) in a cohort of patients with disability due to spinal cord injury. Spinal Cord Ser Cases. 2020;6(1):39. https://doi.org/10.1038/s41394-020-0288-3
  10. Dicks MA, Clements ND, Gibbons CR, Verduzco-Gutierrez M, Trbovich M. Atypical presentation of Covid-19 in persons with spinal cord injury. Version 2. Spinal Cord Ser Cases. 2020;6(1):38. https://doi.org/10.1038/ s41394-020-0289-2
  11. Lo?pez-Dolado E, Gil-Agudo A. Lessons learned from the coronavirus disease 2019 (Covid-19) outbreak in a monographic center for spinal cord injury. Spinal Cord. 2020;58(5):517-9. https://doi.org/10.1038/ s41393-020-0473-z
  12. Alexander M. Pandemics, climate change, and disability related to SCI. Version 2. Spinal Cord Ser Cases. 2020;6(1):36. https://doi.org/10.1038/ s41394-020-0285-6
  13. The British Association of Spinal Cord Injury Specialists. Bascis guidance on management of spinal cord injury patients during coronavirus (covid- 19) pandemic. Available from: https://www.iscos.org.uk/uploads/CV- 19/updated%20files%204%2024%2020/ENG_Basic_guidance_on_management.pdf. Published April 3, 2020. [Accessed May 20, 2020]
  14. Axelson P. Attention: Wheelchair and assistive technology users precau- tions for COVID-19. Available from: http://www.beneficialdesigns.com/ wp-content/uploads/2020/05/WC-AT-COVID-19-wash-gdlns-2020-04-29- 1533.pdf [Accessed May 18, 2020]
  15. Silva RTE, Cristante AF, Marcon RM, Barros-Filho TEP. Medical care for spinal diseases during the COVID-19 pandemic. Clinics. 2020;75:e1954. https://doi.org/10.6061/clinics/2020/e1954
  16. Armitage R, Nellums LB. The COVID-19 response must be disability inclusive. Lancet Public Health. 2020;5(5):e257. https://doi.org/10.1016/ S2468-2667(20)30076-1
  17. Addington-Hall J, Kalra L. Who should measure quality of life? BMJ. 2001;322(7299):1417-20. https://doi.org/10.1136/bmj.322.7299.1417

How to Cite

Azharuddin, A., & Novera, D. (2021). Management of Spinal Cord Injury During COVID-19 Era. Bali Medical Journal, 10(3), 909–911. https://doi.org/10.15562/bmj.v10i3.2430

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