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.

中文翻译：

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COVID-19 和脊髓损伤：住院患者的临床表现、临床病程和临床结果

学习规划

回顾性研究

目标

描述脊髓损伤 (SCI) 和有症状的 COVID-19 感染住院患者的症状/体征、临床病程和结果。

环境

瑞士一所大学医院和两个 SCI 中心。

方法

对有症状的 COVID-19 感染且需要住院治疗的 SCI 患者的症状/体征、临床病程和结果进行描述性分析。

结果

纳入 22 名 SCI 患者，其中 15 名 (68%) 为男性，中位年龄 64.5 岁（四分位距，IQR，52-73 岁）。九人 (41%) 患有四肢瘫痪，八人 (36%) 被归类为运动完全性病变。常见的临床症状是发烧（59%）、咳嗽（54%）、疲劳（50%）和呼吸困难（27%）。最常见的并发症是细菌性肺部重复感染（18%）和急性呼吸窘迫综合征（18%）。 15 人（68%）在住院期间需要氧疗，7 人（32%）需要呼吸机。中位住院时间 (LOS) 为 23 天 (IQR 15–35)，因年龄而异，对于 60 岁以下的患者，中位住院时间为 9 天 (IQR 8–27)，而对于 60 岁以上的患者，中位住院时间为 9 天 (IQR 8–27)。分别为 34 天（IQR 17-39）。总共有 3 人（14%）在住院期间死亡，全部是截瘫老人。

结论

并非所有人都出现发烧和咳嗽等典型症状。与截瘫患者相比，四肢瘫痪患者并没有表现出更差的结果，相反，他们的 LOS 更短，通气需求没有差异，死亡率也没有更高。老年人表现出更长的 LOS。本研究建议密切监督 SCI 人群，以发现 COVID-19 感染的早期体征和症状。