• Marinella D Galea, Michael A Gelman, Vincent P Galea, Krutika Parasar Raulkar, Stephen Kornfeld, Swapna Johnson-Kunjukutty, Gang Li, and Norbert Bräu.
• Spinal Cord Injury and Disorders Department, The James J Peters VAMC, Bronx, New York, USA.
• J Spinal Cord Med. 2021 Jan 19: 1-13.

ObjectiveTo describe the clinical features and disease course of COVID-19 in veterans with spinal cord injury (SCI).DesignCase series of consecutive veterans with SCI treated at a single center.SettingSCI Unit at an urban Veterans Administration hospital at the epicenter of the COVID-19 pandemic in the US.ParticipantsSeven SCI veterans with confirmed COVID-19 infection by PCR; all veterans were male, mean age was 60.6. Five had cervical level of injury, and five had complete injury (AIS A). Six veterans had a BMI > 22; three had chronic obstructive pulmonary disease; three had chronic kidney disease.InterventionsNone.Outcome MeasuresPresence of co-morbidities, diagnostic values, and clinical findings.ResultsEach case presented differently; the most common presenting sign was fever. In the three individuals with critical and fatal infection, pre-existing comorbidities were more common and inflammatory markers were markedly elevated.ConclusionLevel and completeness of SCI did not appear to correlate with COVID-19 severity, as mild and asymptomatic illness was noted in persons with high grade SCI. As has been shown to be the case in the general population, pre-existing comorbidities are the most reliable predictors of severe SARS-CoV-2 infection currently available for persons with chronic SCI. Contrary to concerns that SCI may mask the cardinal signs of COVID-19, such as fever and cough, by way of compromised thermoregulation and thoracoabdominal musculature, such signs were common in our series. To facilitate early detection, prompt treatment, and minimized viral spread, the implementation of preventive strategies by SCI units is recommended.

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