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COVID-19 has been with us for over a year, but it still has some secrets for us. Scientists are constantly studying the effects of coronavirus infection and are constantly discovering new facts. It is so now. It turns out that a complication, not uncommon and also occurring in children, may be myelitis – the so-called ATM. The effects include sudden symptoms of paralysis, pain, paralysis of the lower limbs. Get to know the details of the recently announced study.
- COVID-19 is a threat to the nervous system: the brain, spinal cord and nerves
- “An unexpectedly common neurological complication of COVID-19” is ATM – acute transverse myelitis
- ATM is an inflammation of the spinal cord that damages neurons. The disease manifests itself, inter alia, in tetraplegia / paralysis of both limbs / disorders in sphincter control
- More current information can be found on the Onet homepage.
COVID-19 and its effects on the nervous system. What are the symptoms?
COVID-19 is primarily considered a respiratory disease. However, it has been known for months that SARS-CoV-2 can also attack other organs. This is because the receptors that make it easier for the coronavirus to attach to and penetrate cells are present in many tissues.
Already in the spring of last year, scientists suspected that COVID-19 was also a threat to the nervous system – the brain, spinal cord and nerves. This was also confirmed by the autopsy results of patients who died from COVID-19 and the symptoms observed in patients, including headaches, disturbance of the sense of smell and taste, anxiety, delirium (a state of confusion in which a person feels detached from reality, as if they were dreaming), confusion, forgetfulness, inability to focus, communication problems – referred to as the non-medical term “brain fog” .
- How did COVID-19 affect the brain? The study of convalescents surprised the scientists
A few days ago, a team of scientists from the US and Panama reported another neurological complication after COVID-19. It is a rare inflammatory disease of the spinal cord, namely acute transverse myelitis – the so-called ATM (acute transverse myelitis). The study included documentation of 43 ATM cases reported worldwide between March 2020 and January 2021 (patients came from 21 countries).
Acute transverse myelitis. What is ATM?
First, let’s explain what ATM is. Acute transverse myelitis is an inflammation of the spinal cord that damages the sensory, motor and autonomic neurons of the spinal cord, as well as those that pass through the spinal nerve tract.
As Małgorzata Łukjanowicz, MD, Ph.D. explained in the “Rheumatology Review”, “as a result of the inflammatory process, the symptoms of paralysis usually appear suddenly, or muscle paresis, sharp sensory disturbances and damage to smooth muscles, mainly as damage to the sphincters”.
ATM may occur in the course of connective tissue diseases, including systemic lupus erythematosus (SLE), may appear as an immune reaction after vaccinations, in multiple sclerosis, in bacterial infectious diseases such as Lyme disease, syphilis, tuberculosis, or those with viral etiology – measles, mumps, AIDS.
Sometimes the cause of acute myelitis cannot be determined. Then we are dealing with an idiopathic ATM.
ATM a complication of COVID-19. What did the scientists find?
Let’s go back to our study – what conclusions did scientists from the US and Panama come to? The researchers note that ‘although acute transverse myelitis (ATM) is a rare neurological condition, there have been ATM cases associated with COVID-19 during the pandemic’. Researchers set out to analyze the existing research and documentation of the 43 ATM cases mentioned. What has been found is, in their opinion, sufficient to warrant further research. Here are the details.
Estimates related to the frequency of ATM indicate that there are between 1,34 and 4,6 cases per million people each year. Meanwhile, during that 10-month period of the pandemic, the incidence of acute transverse myelitis among COVID-19 patients alone was approximately 0,5 cases per million. This data was a red flag warning for scientists.
“We found ATM to be an unexpectedly common neurological complication of COVID-19,” they admit. “In most cases (68%) it appeared between 10 days and six weeks, which may indicate neurological complications after infection mediated by the host’s response to the virus.” In 32 percent problems appeared between 15 hours and five days, suggesting direct effects of SARS-CoV-2.
Among the 43 analyzed ATM cases in COVID-19 patients, there were 23 men (53%) and 20 women (47%) aged 21 to 73 (mean age 49). Researchers also found three cases of ATM in children aged three to 14 years, but these were omitted from the analyzes.
In these adults with ATM, the main clinical symptoms were tetraplegia (58%) and paraplegia, i.e. paralysis of both limbs, most often of the lower limbs (42%). The documentation also mentions abnormalities in the control of the sphincters. Eight patients aged 27 to 64 years, mostly women, were diagnosed with acute disseminated encephalomyelitis (ADEM). Three patients with ATM developed Devic’s disease (MNO), i.e. optic nerve inflammation (if left untreated, it quickly leads to permanent blindness).
Scientists: We are still far from understanding everything COVID-19 brings with it
Summarizing the analyzes carried out, the researchers conclude: “This review confirms that ATM is not uncommon among the neurological complications associated with COVID-19 infection. It may be responsible for 1,2 percent. all neurological complications caused by the SARS-CoV-2 coronavirus ».
As mentioned above, ATM is an immune-mediated condition. While this means that the root cause of the disease is unclear, our immune system is involved. The researchers point out that there are some potential immune mechanisms that could explain how SARS-CoV-2 might cause this complication.
Scientists emphasize that further research should yield more answers, but the current situation shows that we are still far from understanding everything COVID-19 entails.
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