Acute Myelitis Secondary to COVID-19 in an Adolescent: Causality or Coincidence ?

Abstract

Coronavirus disease 2019 (COVID-19) first emerged in Wuhan, China in December 2019. Headache, dizziness, attenuated taste/smell, stroke, acute disseminated encephalomyelitis, encephalitis, Guillain-Barré syndrome, and myelitis are rare neurological symptoms and complications reported in adults. A 14-year-old girl presented with sudden-onset loss of strength in her right arm and leg. A nasopharyngeal swab was collected because the patient had a history of suspicious contact with a confirmed COVID-19 patient. SARS-CoV-2 nucleic acid testing of the patient’s nasopharyngeal swab was positive. Her clinical presentation suggested transverse myelitis. On spinal MRI, a contrast-enhancing lesion causing expansion at the C2-C5 level was observed. On day 5 of pulse methylprednisolone treatment, the patient had 3/5 muscle strength in her right upper extremity and 5/5 muscle strength in her right lower extremity. This case emphasizes that during the pandemic, SARS-CoV-2 must be considered as the etiology in children presenting with neurological involvement if there is a history of contact.