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      COVID-19 and spinal cord injury and disease: results of an international survey

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          Abstract

          Study design

          An online survey.

          Objectives

          To query the international spinal cord medicine community’s engagement with and response to the novel coronavirus (COVID-19) pandemic and to assess pandemic-specific information needs and patient concerns.

          Setting

          An international collaboration of authors and participants.

          Methods

          Two near-identical surveys (one English and one Spanish language) were distributed via the internet. Responses from those questions shared between the surveys were pooled then analyzed; four questions’ responses (those not shared) were analyzed separately.

          Results

          A total of 783 responses were submitted from six continents. Few participants (5.8%) had tested their outpatients with SCI/D for COVID-19; only 4.4% reported having a patient with SCI/D with the virus. Of respondents who worked at an inpatient facility, 53.3% reported that only individuals with symptoms were being screened and 29.9% said that no screening was occurring. Participants relayed several concerns offered by their patients with SCI/D, including vulnerability to infection (76.9%) and fragility of caretaker supply (42%), and those living in countries with guaranteed health care were more likely to report widespread availability of COVID-19 testing than were those living in countries without universal care, χ 2 (3, N = 625) = 46.259, p < 0.001.

          Conclusion

          There is substantial variability in the rehabilitation medicine community in COVID-19 screening practices and availability of screening kits. People living with SCI/D are expressing legitimate and real concerns about their vulnerability to COVID-19. More and rapid work is needed to address these concerns and to standardize best-practice protocols throughout the rehabilitation community.

          Related collections

          Most cited references6

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          Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

          Summary Background In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding National Key R&D Program of China.
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            Recent trends in mortality and causes of death among persons with spinal cord injury.

            To identify and quantify trends in mortality and causes of death among persons with spinal cord injury. Cohort study. Model spinal cord injury care systems and Shriner's Hospitals spinal cord injury units throughout the United States. A total of 28,239 consecutive persons admitted to the model system or to a Shriner's Hospital within 1 year of injury. Length of survival and cause of death. Among persons who were admitted to the model system within 1 day of injury, the odds of dying during the first postinjury year were reduced by 67% for persons injured between 1993 and 1998 relative to persons injured between 1973 and 1977 after adjusting for trends in age, gender, race, neurologic level of injury, Frankel grade, ventilator status, etiology of injury, sponsor of care, and model system where treatment occurred. However, mortality rates after the first anniversary of injury, which had also been declining from 1973 to 1992, increased 33% for persons injured between 1993 and 1998 relative to persons injured between 1988 and 1992. Respiratory disease was the only cause of death after the first anniversary of injury for which the relative odds increased meaningfully during the latest time period (76% increase over 1988-1992 compared to all other causes). While great improvements in life expectancy have been achieved since the Model SCI Systems program began, current data support the need for renewed efforts to improve the prevention and treatment of the complications of spinal cord injury.
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              • Article: not found

              Telehealth for people with spinal cord injury: a narrative review

              Narrative review.
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                Author and article information

                Contributors
                Michael.stillman@jefferson.edu
                Journal
                Spinal Cord Ser Cases
                Spinal Cord Ser Cases
                Spinal Cord Series and Cases
                Nature Publishing Group UK (London )
                2058-6124
                15 April 2020
                2020
                : 6
                : 21
                Affiliations
                [1 ]ISNI 0000 0001 2166 5843, GRID grid.265008.9, Sidney Kimmel Medical College of Thomas Jefferson University, ; Philadelphia, PA USA
                [2 ]Telerehabilitation International, Rome, Italy
                [3 ]Direccion de Discapacidad de Ituzaingo Secretaria de Salud, Buenos Aires, Argentina
                [4 ]ISNI 0000 0001 0692 3437, GRID grid.417778.a, Spinal Unit and Spinal Rehabilitation (SpiRe) Lab, IRCCS Fondazione S. Lucia, ; Rome, Italy
                Author information
                http://orcid.org/0000-0001-5766-6952
                Article
                275
                10.1038/s41394-020-0275-8
                7156806
                32296046
                ca1356ef-ee50-43fd-b820-c07304d8d593
                © The Author(s), under exclusive licence to International Spinal Cord Society 2020

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 28 March 2020
                : 29 March 2020
                : 30 March 2020
                Categories
                Article
                Custom metadata
                © International Spinal Cord Society 2020

                viral infection,spinal cord diseases
                viral infection, spinal cord diseases

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