ABSTRACT
Objective: To present a case of a longitudinal myelitis (LM) in the setting of SARS-CoV-2 infection. Background: While there is an established link between viral infections and new-onset demyelinating diseases [1, 2], data on the association between SARS-CoV-2 and myelitidies is lacking. Design/Methods: Consent obtained from patient. Results: A 53-year-old man presented with epigastric pain and urinary retention following ten days of fever, chills, headache, and cough. On presentation, he tested positive for SARS-CoV-2, prompting admission, then subsequently developed bilateral lower extremity weakness and numbness. MRI revealed T2 cord hyperintensity from C7 caudally to the conus. CSF revealed elevated total protein (67), WBC (16), IgG (11.1), and myelin-based protein (9). Testing for other demyelinating, infectious, and inflammatory conditions was negative. He had modest improvement in sensation following intravenous methylprednisolone and plasma exchange although remains paraplegic. Conclusions: This unique case of a longitudinal myelitis in the setting of SARS-CoV-2 infection adds to previously reported cases of acute disseminated encephalomyelitis, meningoencephalitis, and optic neuritis as neurological manifestations of SARS-CoV-2 infections [2].
ABSTRACT
Purpose The COVID-19 pandemic has actively changed the face of all medical disciplines, including mental health practices. In a matter of days from the introduction of the lockdown, clinicians have to adapt to new working models with many changing the consultation methods clinicians have utilized for years. To best understand the wider clinical impact, a limited study was carried out to assess the effect of coronavirus disease 2019 (COVID-19) on psychiatric clinical practice. Design/methodology/approach A qualitative study was performed to analyze the impact of COVID-19 on clinician practice at a UK secure care mental health facility. A four-question free-text survey was distributed online to all physicians and seven responses were analyzed using thematic analysis. Findings Four key themes were identified - use of technology, the importance of face-to-face contact, work/life balance and mental well-being. Practical implications Overall, the results of the study reported that although some negative changes to the traditional work-life balance were identified, the clinicians found remote working within a secure care setting cultivated a more efficient working environment while allowing for more effective social distance practices. Originality/value This study highlighted some of the challenges faced by clinicians employed in a secure care mental health setting following the introduction of lockdown measures in the UK associated with the COVID-19 pandemic. The study will also inform future work practices, including the potential of longer term remote working in this sector.