Inge E. Eriks-Hoogland, Michael A. Barth, Lorena L. Müller, et. al. Spinal Cord Series and Cases volume 10, Article number: 5 (2024) 

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 hospitalization.

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 dyspnea (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 hospitalization, 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.