Abstract

ESCOBAR PEREZ, Laura; RIO QUINONES, Manuel Alejandro del  and  VACA, Luis. Acute Transverse Myelitis Associated to SARS-CoV-2 Infection. Rev. Fac. Med. (Méx.) [online]. 2023, vol.66, n.1, pp.8-23.  Epub May 12, 2023. ISSN 2448-4865.  https://doi.org/10.22201/fm.24484865e.2023.66.1.02.

In addition to causing respiratory problems, SARS-CoV-2 can cause a wide spectrum of neurological complications such as headaches, ageusia, anosmia, encephalopathy, cerebrovascular disease, Guillain-Barré syndrome and other polyneuropathies, meningoencephalitis, acute necrotizing hemorrhagic encephalopathy, and central nervous system syndromes associated with inflammation. In this review we present 39 cases of acute transverse myelitis (ATM) associated to SARS-CoV-2 infection. All cases had a positive polymerase chain reaction (PCR) nasopharyngeal swab and/or antigen test. Biochemical analyses confirmed the absence of other pathogens and autoantibody-mediated neuroinflammatory disease, except for two cases, one with autoantibodies against the oligodendrocyte myelin glycoprotein (anti-MOG IgG) and another with anti-MOG IgG and anti-glutamic acid decarboxylase (anti-GAD65). Magnetic Resonance Imaging (MRI) studies confirmed the diagnosis of ATM. Although causality cannot be inferred, it is likely that isolated cases of ATM are the consequence of a para or post-infectious process in SARS-CoV-2. In this work, the probable causes of ATM associated with SARS-CoV-2 are discussed. The understanding of the mechanisms behind these neurological disorders triggered by a viral infection will help to optimize the therapeutic strategies for patient management.

Keywords : SARS-CoV-2; COVID-19; transverse myelitis; long COVID; demyelination; nervous system.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )