COVID-19 associated myelitis: case series




Myelitis, COVID, Longitudinally extensive transverse myelitis, Short-segment myelitis


The coronavirus pandemic brought with it a wide range of clinical presentations. Earlier, the respiratory symptoms comprised most of the clinical picture. However, as more and more people got infected, many atypical presentations came into the limelight, especially the neurological manifestations. Spinal cord complications are widely reported, with COVID-19 associated myelitis constituting a big part. Through this report, we bring you a series of cases of COVID-19 associated myelitis to add to the already available data. We report four patients, two of whom developed longitudinally extensive myelitis (three or more vertebral segments). The other two suffered from multisegmented short-segment myelitis (less than three vertebral segments). COVID-19 myelitis can be seen during COVID-19 illness and post COVID. We aim to familiarize the medical community with this entity so that there is a minimum delay between the onset of the symptoms in the patient and the management of this complication, as the treatment is often gratifying.

Author Biographies

Vineet Sehgal, Department of Neurology, Amandeep Medicity, Amritsar, Punjab, India

Chief of Neurology

Shaifali Arora, Department of Neurology, Sehgals Neuro and Child Care Centre, Amritsar, Punjab, India

Medical Officer, Department of Neurology

Priyanshu Bansal, Department of Neurology, Sehgals Neuro and Child Care Centre, Amritsar, Punjab, India

Medical Officer, Department of Neurology

Saniya Kapila, Fortis Escorts, Amritsar, Punjab, India

Resident medical officer

Gaganpreet S. Bedi, Department of Neurology, Amandeep Medicity, Amritsar, Punjab, India

Consultant Radiologist


Romá n GC, Spencer PS, Reis J, Bouguet A, El Alaoui Faris M, Katrak SM, et al. The neurology of COVID-19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries. J Neurol Sci. 2020;414:116884.

Mondal R, Deb S, Shome G, Ganguly U, Lahiri D, Benito-León J. COVID-19 and emerging spinal cord complications: A systematic review. Mult Scler Relat Disord. 2021;51:102917.

Abdelhady M, Elsotouhy A, Vattoth S. Acute Flaccid Myelitis in COVID-19. BJR Case Rep. 2020;6:20200098.

Zelada-Ríos L, Pacheco-Barrios K, Galecio-Castillo M, Yamunaqué-Chunga C, Álvarez-Toledo K, Otiniano-Sifuentes R. Acute disseminated encephalomyelitis and COVID-19: A systematic synthesis of worldwide cases. J Neuroimmunol. 2021;359:577674.

Lim SW, Wong E. Spontaneous Epidural Hematoma of the Cervical Spine in an Elderly Woman with Recent COVID-19 Infection: A Case Report. Am J Case Rep. 2020;21:e926784.

Román GC, Gracia F, Torres A, Palacios A, Gracia K, Harris D. 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.

Soh P, Doan N, Manning B, Doan H. Spinal Cord Injury From an Epidural Abscess as a Serious Complication of COVID-19 Infection. Cureus. 2020;12:e11327.

Barnes G, Benjamin S, Bowen JD, Cutter N, De Lateur BJ, Dietrich WD et al. Proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology. 2002;59:499-505.

Toledano M. Infectious Myelopathies. Continuum (MinneapMinn). 2021;27:93-120.

Lopez Chiriboga S, Flanagan EP. Myelitis and Other Autoimmune Myelopathies. Continuum (MinneapMinn). 2021;27:62-92.

Schulte EC, Hauer L, Kunz AB, Sellner J. Systematic review of cases of acute myelitis in individuals with COVID-19. Eur J Neurol. 2021;28:3230-44.

Ali L, Mohammed I, Zada Y, Salem H, Iqrar A. COVID-19-Associated Acute Transverse Myelitis: A Case Series of a Rare Neurologic Condition. Cureus. 2021;13:e18551.

Arslan D, Acar-Ozen P, Gocmen R, Elibol B, Karabudak R, Tuncer A. Post-COVID-19 longitudinally extensive transverse myelitis: is it a new entity?. Neurol Sci. 2022;43:1569-73.

Kaur H, Mason JA, Bajracharya M, McGee J, Gunderson MD, Hart BL, et al. Transverse Myelitis in a Child With COVID-19. Pediatr Neurol. 2020;112:5-6.

Schett G, Sticherling M., Neurath MF. COVID-19: risk for cytokine targeting in chronic inflammatory diseases?. Nat Rev Immunol. 2020;20:271-2.

Blackburn KM, Wang C. Post-infectious neurological disorders. Ther Adv Neurol Disord. 2020;13:1756286420952901.






Case Series