Acute Cord Compression Left Untreated for Fear of Contracting COVID-19: A Case Report and a Call for Health Care Plans for Oncologic Emergencies during Crisis.

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a pandemic that started in Wuhan city, Hubei province in China in December 2019 and is associated with high morbidity and mortality. This pandemic has overwhelmed health care systems in the USA, Europe and many other countries around the globe. Several health care institutions, including ours, SUNY-Downstate Health Science University in Brooklyn, New York, were designated as COVID-only hospitals. At the same time, patients with other serious illnesses refrained from seeking medical care because of the fear of contracting the virus at the health care facilities. In this report, we present a case of an octogenarian woman with breast cancer who was treated initially with radical mastectomy and chemotherapy, who then developed back pain in mid-March 2020, that later progressed to bilateral lower extremity weakness secondary to cord compression, which was diagnosed nearly 4 weeks after her initial symptoms started. The patient had refrained from seeking medical care citing fear of contracting COVID-19 in the hospital. This case illustrates the dire need to establish mechanisms within our health care system to manage oncologic (and other life or limb threatening) emergencies during times such as the COVID-19 pandemic.