Background: : Spinal cord complications associated with coronavirus infectious disease of 2019 (COVID-19) are being widely reported . The purpose of this systematic review was to summarize so far available pieces of evidence documenting novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) mediated spinal cord demyelinating diseases .
Methods: : We used the existing PRISMA consensus statement . Data were collected from PubMed, NIH Litcovid, EMBASE and Cochrane library databases, as well as Pre-print servers (medRxiv, bioRxiv, and pre-preints.org), until September 10 , 2020, using pre-specified searching strategies .
Results: : The 21 selected articles were all case reports and included 11 (52 %) men and 10 (48 %) women . The mean age was of 46.7±18.0.The neurological manifestations included weakness, sensory deficit, autonomic dysfunction, and ataxia . In most cases, elevated cerebrospinal fluid protein as well as lymphocytic pleocytosis were found . SARS-CoV-2 was detected in five (24 %) patients, meanwhile in 13 (62 %) patients, the testing was negative . Testing was not performed in two cases and, in one, data were unavailable . Nearly half of the cases (N=9) were associated with isolated long extensive transverse myelitis (LETM), whereas a combination of both LETM and patchy involvement was found in two . Only five patients had isolated short segment involvement and two patchy involvement . Furthermore, concomitant demyelination of both brain and spine was reported in six patients . Concerning the prognosis, most of the patients improved and the mortality rate was low (N = 2, <10 %). Conclusion: : Spinal cord demyelination should be added to the plethora of immune mediated neurologic complications associated with COVID-19.