Acute disseminated encephalomyelitis and myelitis associated with new coronavirus infection COVID-19. Case report

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Abstract

Acute disseminated encephalomyelitis (AEM) and acute transverse myelitis (OPM) are autoimmune demyelinating diseases of the central nervous system. Two clinical observations of AEM and OPM developed after suffering acute coronavirus infection (SARS-CoV-2) are presented. Differential diagnosis was carried out with multiple sclerosis, encephalitis of an infectious nature, compressive myelopathy, and opticomyelitis. Both observations show an almost complete recovery of lost functions. The pathogenetic mechanisms of the development of AEM and OPM in patients with coronavirus infection are discussed. The onset of central nervous system dysimmune lesion in the context of coronavirus infection makes it necessary to monitor the clinical situation with the involvement of a neurologist for timely diagnosis and determination of therapeutic tactics that can reduce the degree of disability of patients.

About the authors

Luiza T. Akhmedzhanova

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: luiziana78@mail.ru
ORCID iD: 0000-0002-7384-6715

канд. мед. наук, доц. каф. нервных болезней и нейрохирургии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Olga N. Voskresenskaia

Sechenov First Moscow State Medical University (Sechenov University)

Email: luiziana78@mail.ru
ORCID iD: 0000-0002-7330-633X

д-р мед. наук, проф. каф. нервных болезней и нейрохирургии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Aleksei I. Isaikin

Sechenov First Moscow State Medical University (Sechenov University)

Email: luiziana78@mail.ru
ORCID iD: 0000-0003-4950-144X

канд. мед. наук, доц. каф. нервных болезней и нейрохирургии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Elizaveta V. Ermilova

Sechenov First Moscow State Medical University (Sechenov University)

Email: luiziana78@mail.ru
ORCID iD: 0000-0001-5008-1265

соискатель ученой степени кандидата медицинский наук на каф. нервных болезней и нейрохирургии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Tatiana I. Nasonova

Sechenov First Moscow State Medical University (Sechenov University)

Email: luiziana78@mail.ru
ORCID iD: 0000-0003-4971-9254

аспирант каф. нервных болезней и нейрохирургии Института клинической медицины им. Н.В.Склифосовского, врач-невролог 3-го неврологического отд-ния Клиники нервных болезней им. А.Я. Кожевникова

Russian Federation, Moscow

Pavel A. Chernousov

Sechenov First Moscow State Medical University (Sechenov University)

Email: luiziana78@mail.ru
ORCID iD: 0000-0003-2143-1806

клинический ординатор каф. нервных болезней и нейрохирургии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Vladimir V. Rusin

Sechenov First Moscow State Medical University (Sechenov University)

Email: luiziana78@mail.ru
ORCID iD: 0000-0001-9731-2622

врач-невролог 1-го неврологического отд-ния Клиники нервных болезней им. А.Я. Кожевникова

Russian Federation, Moscow

References

  1. Divani AA, Andalib S, Biller J, at al. Central Nervous System Manifestations Associated with COVID-19. Curr Neurol Neurosci Rep. 2020;20(12):1-20. doi: 10.1007/s11910-020-01079-7
  2. Paterson RW, Brown RL, Benjamin L, et al. The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings. Brain. 2020;143:3104-20. doi: 10.1093/brain/awaa240
  3. Varatharaj A, Thomas N, Ellul MA, et al. Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study. Lancet Psychiatry. 2020;7:875-82. doi: 10.1016/S2215-0366(20)30287-X
  4. Maury A, Lyoubi A, Peiffer-Smadja N, et al. Neurological manifestations associated with SARS-CoV-2 and other coronaviruses: A narrative review for clinicians. Rev Neurol (Paris). 2021;177(1-2):51-64. doi: 10.1016/j.neurol.2020.10.001
  5. Неврология (национальное руководство). Под ред. Е.И. Гусева, А.Н. Коновалова, В.И. Скворцовой. 2018. М.: ГЭОТАР-Медиа. Т. 1. С. 478-83, 489-95. [Neurology (national guide). Ed. EI Gusev, AN Konovalov, VI Skvortsova. 2018. Moscow: GEOTAR-Media. Vol. 1. P. 478-83, 489-95 (in Russian)].
  6. Koelman DLH, Chahin S, Mar SS, et al. Acute disseminated encephalomyelitis in 228 patients: a retrospective, multicenter US study. Neurology. 2016;86(22):2085-93. doi: 10.1212/WNL.0000000000002723
  7. Parsons T, Banks S, Bae C, et al. COVID-19-associated acute disseminated encephalomyelitis (ADEM). J Neurol. 2020. doi: 10.1007/s00415-020-09951-9
  8. Lopes CCB, Brucki SMD, Passos Neto CEB, et al. Acute Disseminated Encephalomyelitis in COVID-19: presentation of two cases and review of the literature. Arq Neuropsiquiatr. 2020;78(12):805-10. doi: 10.1590/0004-282X20200186
  9. McCuddy M, Kelkar P, Zhao Y, Wicklund D. Acute Demyelinating Encephalomyelitis (ADEM) in COVID-19 Infection: A Case Series. Neurol India. 2020;68(5):1192-5. doi: 10.4103/0028-3886.299174
  10. Otluoglu GD, Yener U, Demir MK, Yilmaz B. Encephalomyelitis associated with COVID-19 infection: Case report. Br J Neurosurg. 2020;1–3. doi: 10.1080/02688697.2020.1787342
  11. Novi G, Rossi T, Pedemonte E, et al. Acute disseminated encephalomyelitis after SARS-CoV-2 infection. Neurol Neuroimmunol Neuroinflamm. 2020;7(5):e797. doi: 10.1212/NXI.0000000000000797
  12. Utukuri PS, Bautista A, Lignelli A, Moonis G. Possible acute disseminated encephalomyelitis related to severe acute respiratory syndrome coronavirus 2 infection. AJNR Am J Neuroradiol. 2020;41(9):E82-3. doi: 10.3174/ajnr.A6714
  13. Langley L, Zeicu C, Whitton L, Pauls M. Acute disseminated encephalomyelitis (ADEM) associated with COVID-19. BMJ Case Rep. 2020;13(12):e239597. doi: 10.1136/bcr-2020-239597
  14. Hussein O, Abd Elazim A, Torbey MT. COVID-19 systemic infection exacerbates pre-existing acute disseminated encephalomyelitis (ADEM). J Neuroimmunol. 2020;349:577405. doi: 10.1016/j.jneuroim.2020.577405
  15. Reichard RR, Kashani KB, Boire NA, et al. Neuropathology of COVID-19: a spectrum of vascular and acute disseminated encephalomyelitis (ADEM) like pathology. Acta Neuropathologica. 2020;140:1-6. doi: 10.1007/s00401-020-02166
  16. Román GS, Gracia F, Torres A, et al. Acute Transverse Myelitis (ATM): Clinical Review of 43 Patients With COVID-19-Associated ATM and 3 Post-Vaccination ATM Serious Adverse Events With the ChAdOx1 nCoV-19 Vaccine (AZD1222). Front Immunol. 2021;12:653786. doi: 10.3389/fimmu.2021.653786
  17. Águila-Gordo D, Manuel Flores-Barragán J, Ferragut-Lloret F, et al. Acute myelitis and SARS-CoV-2 infection. A new etiology of myelitis? J Clin Neurosci. 2020;80:280-1. doi: 10.1016/j.jocn.2020.07.074
  18. Zubair AS, McAlpine LS, Gardin T, et al. Neuropathogenesis and neurologic manifestations of the coronaviruses in the age of coronavirus disease 2019: A review. JAMA Neurol. 2020;77:1018-27. doi: 10.1001/jamaneurol.2020.2965
  19. Ng Kee Kwong KC, Mehta PR, Shukla G, Mehta AR. COVID-19, SARS and MERS: A neurological perspective. J Clin Neurosci. 2020;7:13-6. doi: 10.1016/j.jocn.2020.04.124
  20. Бойко А.Н., Сиверцева С.А., Спирин Н.Н. Поражение нервной системы при инфекции COVID-19 с акцентом на ведение пациентов с рассеянным склерозом. Неврология, нейропсихиатрия, психосоматика. 2020;12 (Прил. 1):44-7 [Boyko AN, Sivertseva SA, Spirin NN. Nervous system damage in COVID-19 with an emphasis on the management of patients with multiple sclerosis. Neurology, Neuropsychiatry, Psychosomatics. 2020;12(Suppl. 1):44-7 (in Russian)]. doi: 10.14412/2074-2711-2020-1S-44-47
  21. Белопасов В.В., Яшу Я., Самойлова Е.М., Баклаушев В.П. Поражение нервной системы при СOVID-19. Клиническая практика. 2020;11(2):60-80 [Belopasov VV, Yachou Y, Samoilova EM, Baklaushev VP. The Nervous System Damage in COVID-19. Journal of Clinical Practice. 2020;11(2):60-80 (in Russian)]. doi: 10.17816/clinpract34851
  22. Sarma D, Bilello LA. A case report of acute transverse myelitis following novel coronavirus infection. Clin Pract Cases Emerg Med. 2020;4:321-3. doi: 10.5811/cpcem.2020.5.47937
  23. Advani S, Zali A, Ommi D, et al. Transverse myelitis in COVID-19 patients: Report of two cases. Res Square. 2020. Preprint. doi: 10.21203/rs.3.rs-107744/v1
  24. Valiuddin H, Skwirsk B, Paz-Arabo P. Acute transverse myelitis associated with SARS-CoV-2: A case report. Brain Behav Immun Health. 2020;5:100091. doi: 10.1016/j.bbih.2020.100091
  25. Zachariadis A, Tulbu A, Strambo D, et al. Transverse myelitis related to COVID-19 infection. J Neurol. 2020;267:3459-61. doi: 10.1007/s00415-020-09997-9
  26. Garg RK, Paliwal VK, Gupta A. Spinal cord involvement in COVID-19: A review. J Spinal Cord Med. 2021:1-15. doi: 10.1080/10790268.2021.1888022
  27. AlKetbi R, AlNuaimi D, AlMulla M, et al. Acute myelitis as a neurological complication of COVID-19: A case report and MRI findings. Radiol Case Rep. 2020;15:1591-5. doi: 10.1016/j.radcr.2020.06.001
  28. Chakraborty U, Chandra A, Ray AK, Biswas P. COVID-19-associated acute transverse myelitis: A rare entity. BMJ Case Rep. 2020;13:e238668. doi: 10.1136/bcr-2020-238668
  29. Munz M, Wessendorf S, Koretsis G, et al. Acute transverse myelitis after COVID-19 pneumonia. J Neurol. 2020;267(8):2196-7. doi: 10.1007/s00415-020-09934-w
  30. Luis MB, Liguori NF, López PA, Alonso R. SARS-CoV-2 RNA detection in cerebrospinal fluid: Presentation of two cases and review of literature. Brain Behav Immun Health. 2021;15:100282. doi: 10.1016/j.bbih.2021.100282
  31. Воскресенская О.Н., Коваленко А.А., Надбитова Е.Б., и др. Центральный понтинный миелинолиз на фоне инфекции SARS-CoV-2 (клинические наблюдения). Неврология, нейропсихиатрия, психосоматика. 2021;13(2):91-6 [Voskresenskaya ON, Kovalenko АА, Nadbitova ЕB, et al. Central pontine myelinolysis in the presence of SARS-CoV-2 infection (clinical observations). Neurology, Neuropsychiatry, Psychosomatics. 2021;13(2):91-6 (in Russian)]. doi: 10.14412/2074-2711-2021-2-91-96

Supplementary files

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2. Fig. 1. Brain magnetic resonance imaging (MRI), T2-weighted image of patient A. dated 18.01.2021.

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3. Fig. 2. T1-weighted MRI of patient A. dated 10.03.2021. Pathological accumulation of contrast in the left cerebellar hemisphere (a) and periventricular region on the right (b).

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4. Fig. 3. T1-weighted MRI of the cervical spinal cord in patient G. dated 08.05.2021. Focal changes in the MR signal in CII – CIII segments: a – sagittal section; b – axial section.

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