A Survey of the Spinal Cord Medicine Community's Response to COVID-19 in the Early Months of the Pandemic


The emergence and spread of a novel coronavirus have resulted in a coronavirus disease (COVID-19) pandemic. In the early months of the pandemic, little was known about the impact of the virus on people with other conditions and comorbidities, including spinal cord injury (SCI). Patients with SCI are particularly vulnerable to infections and other disease-related complications, therefore researchers are interested to know how the international spinal cord medical community has engaged with and responded to COVID-19, including efforts to assess pandemic-specific needs and to address patients’ concerns about the disease.

In March 2020, a research team developed and distributed two surveys to determine how health care professionals have assessed, screened, and treated their SCI patients for potential COVID-19 infections. The survey received responses from 783 health care professionals across six continents (with high representation from Europe and North America), including rehabilitation physicians, therapists, nurses, mental health professionals, and general practitioners. After analyzing the results of the survey, the research team found that:

  • Less than 6% of the respondents had tested their SCI patients for COVID-19, and only 4.4% reported treating an SCI patient who was confirmed to have the virus.
  • About half of respondents working in inpatient facilities reported that only individuals with symptoms received screening for COVID-19. About one-third reported that no screening occurred, even among symptomatic individuals.
  • About 66% of respondents reported following the COVID-19 guidelines published by their government.
  • Health care professionals expressed concern that their SCI patients were highly vulnerable to infection. Many also feared that the caretaker workforce for SCI patients would dwindle as a significant proportion of health care providers would be reassigned to treat COVID-19 patients.

Given the rapidly emerging nature of the COVID-19 pandemic, these results reflect behaviors and attitudes as of early March 2020, when only 466,000 people were diagnosed with COVID-19 and only 21,000 people had died from it. Even so, this study provides valuable information about the uneven—often nonexistent—early global response to COVID-19 among health care workers who treat vulnerable populations, such as SCI patients. The long-term effects of COVID-19 on these patients (and those with other comorbidities) remains unknown. To ensure the health and safety of all communities, there remains an urgent need to develop standard screening and treatment protocols for COVID-19 in health care facilities worldwide.

Stillman MD, Capron M, Alexander M, et al. COVID-19 and spinal cord injury and disease: results of an international survey. Spinal Cord Society. (April 2020).

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