ritonavir and Spinal-Cord-Injuries

We present the report of the first, to our best knowledge, case of COVID-19 in a tetraplegic person.. A 56-year-old male with AIS A C4 tetraplegia developed fever during the night, without any prodrome. His general practitioner suspected a urinary tract infection and prescribed him antibiotic therapy. After 2 days of antibiotic therapy the fever still persisted, so the individual was admitted to the local hospital and treated with broad-spectrum antibiotics. After 2 days he was transferred to our spinal unit. Considering the worsening of the chest X-ray and fever despite 48 h of broad-spectrum antibiotic therapy, we strongly suspected viral pneumonia. SARS-CoV-2 was detected and antiviral therapy with Lopinavir/Ritonavir, associated with hydroxychloroquine, was promptly started. Fever ceased after 2 days of therapy.. Blood test and chest X-ray findings in this patient were similar to previously published findings regarding COVID-19. One difference between this case and the known clinical course of COVID-19 is that did not develop cough. Another interesting feature of our case is that, despite tetraplegia, the clinical course was not severe. Persons with COVID-19 remain asymptomatic, these results underscore the need for rehabilitation and SCI professionals to have a high index of suspicion for COVID-19 in their inpatient and outpatient clients. Only inpatient with fever hase being tested for COVID-19. All new patients are submitted to SARS-COV-2 Test. Moreover, routine testing of patients who have to participate in therapy in common gym areas may be warranted.

Topics: Anti-Bacterial Agents; Anti-Retroviral Agents; Clinical Laboratory Techniques; Coronavirus Infections; Cough; COVID-19; COVID-19 Testing; Fever; Hospitalization; Humans; Italy; Lopinavir; Male; Middle Aged; Pandemics; Pneumonia, Viral; Quadriplegia; Respiration, Artificial; Ritonavir; Severe acute respiratory syndrome-related coronavirus; Spinal Cord Injuries

Observational case-control study.. Individuals with spinal cord injury (SCI) develop systemic physiological changes that could increase the risk of severe evolution of coronavirus disease 2019 (COVID-19) and result in atypical clinical features of COVID-19 with possible delay in both diagnosis and treatment. We evaluated differences in clinical features and evolution of COVID-19 between people with SCI and able-bodied individuals.. The study was conducted in an Italian inpatient rehabilitation referral center for individuals with SCI during the lockdown for the COVID-19 pandemic.. We compared clinical information between patients with SCI and able-bodied healthcare workers of the same center who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the nasopharyngeal swab polymerase chain reaction.. Overall, 15 out of the 25 SCI patients admitted to the center and 17 out of the 69 healthcare workers tested positive for SARS-CoV-2. Patients with SCI exhibited a significantly more advanced age and a higher prevalence of comorbidities. Nevertheless, no significant differences in clinical expression of COVID-19 and treatment strategies were observed between the two groups. All hospitalized subjects were treated in nonintensive care units and no deaths occurred in either group.. This study does not support the supposed notion that COVID-19 could exhibit atypical clinical features or a worse evolution in the frail population of people with SCI.

Topics: Adult; Aged; Anti-Bacterial Agents; Antibodies, Monoclonal, Humanized; Anticoagulants; Antiviral Agents; Azithromycin; Betacoronavirus; Case-Control Studies; Coronavirus Infections; COVID-19; COVID-19 Drug Treatment; Drug Combinations; Enzyme Inhibitors; Female; Heparin, Low-Molecular-Weight; Humans; Hydroxychloroquine; Italy; Lopinavir; Male; Middle Aged; Oxygen Inhalation Therapy; Pandemics; Pneumonia, Viral; Prognosis; Rehabilitation Centers; Ritonavir; SARS-CoV-2; Spinal Cord Injuries