Perception of the COVID-19 pandemic among people with spinal cord injury: an Italian survey.

STUDY DESIGN: An observational study based on an online survey to explore if the participant had experienced (1) cancellation or delay of scheduled health services (2) reduction of assistance provided by a caregiver (3) barriers to social participation and recreational activities. Three validated questionnaires to investigate well-being and symptoms of anxiety and depression were also administered. OBJECTIVES: Our main aim was to quantify the obstacles experienced by adults living with SCI in Italy during COVID-19 pandemic, to explore the presence of depression and anxiety symptoms and to quantify subjective well-being. SETTING: Outpatient clinic of a Spinal Unit in Italy. METHODS: Online survey via direct contact and by e-mail lists. RESULTS: In total, 101 individuals completed the survey. Of, 82.2% participants reported a history of deferment or cancellation of non-COVID-19 health services. The majority (56.4%) revealed that, at least seldom, they have chosen to reduce their usual everyday activities and more than one third (37.6%) affirmed that they had been forced to renounce to one or more of their occupations. Discontinuation of assistance by caregivers was uncommon. The median score of questionnaires measuring depression and anxiety symptoms do not differ significatively when compared with prior studies. The variable that explored the limitations experienced in everyday activities showed a significant correlation with the results of the questionnaires measuring well-being and symptoms of anxiety. CONCLUSIONS: We believe that our results could contribute to the discussion ongoing inside our community on how to answer to the new challenges of this pandemic period and of the post-pandemic future.

COVID-19 tsunami: the first case of a spinal cord injury patient in Italy.

INTRODUCTION: We present the report of the first, to our best knowledge, case of COVID-19 in a tetraplegic person. CASE PRESENTATION: 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. DISCUSSION: 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.