Acute Cord Compression Left Untreated for Fear of Contracting COVID-19: A Case Report and a Call for Health Care Plans for Oncologic Emergencies during Crisis

Mark Ashamalla¹, Hira Chaudhary², Gil Hevroni², Moro O. Salifu² and Samy I. McFarlane^2,

¹Radiation Oncology Department, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY USA

²Department of Medicine, Downstate-Health Science University, Brooklyn, NY USA

Cite this paper

Mark Ashamalla, Hira Chaudhary, Gil Hevroni, Moro O. Salifu and Samy I. McFarlane. Acute Cord Compression Left Untreated for Fear of Contracting COVID-19: A Case Report and a Call for Health Care Plans for Oncologic Emergencies during Crisis. American Journal of Medical Case Reports. 2020; 8(11):397-399. doi: 10.12691/AJMCR-8-11-5

Abstract

Coronavirus disease 2019 (COVID-19) is a pandemic that started in Wuhan city, Hubei province in China in December 2019 and is associated with high morbidity and mortality. This pandemic has overwhelmed health care systems in the USA, Europe and many other countries around the globe. Several health care institutions, including ours, SUNY-Downstate Health Science University in Brooklyn, New York, were designated as COVID-only hospitals. At the same time, patients with other serious illnesses refrained from seeking medical care because of the fear of contracting the virus at the health care facilities. In this report, we present a case of an octogenarian woman with breast cancer who was treated initially with radical mastectomy and chemotherapy, who then developed back pain in mid-March 2020, that later progressed to bilateral lower extremity weakness secondary to cord compression, which was diagnosed nearly 4 weeks after her initial symptoms started. The patient had refrained from seeking medical care citing fear of contracting COVID-19 in the hospital. This case illustrates the dire need to establish mechanisms within our health care system to manage oncologic (and other life or limb threatening) emergencies during times such as the COVID-19 pandemic.

Keywords

COVID-19, oncologic emergencies, cord compression, breast cancer

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Hamel, Liz, Kearney, Audrey, et al., KFF Health Tracking Poll, (KFF, May 22, 2020), https://www.kff.org/coronavirus-covid-19/report/kff-health-tracking-poll-may-2020/.
[2]	Garcia, Santiago, et al. "Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic." Journal of the American College of Cardiology (2020).
[3]	Harris, Patrice A. “We can’t let essential care become another casualty of COVID-19.” American Medical Association, 3 June 2020.
[4]	Liang, Wenhua, et al. "Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China." The Lancet Oncology 21.3 (2020): 335-337.
[5]	Wu, Zunyou, and Jennifer M. McGoogan. "Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention." Jama 323.13 (2020): 1239-1242.
[6]	Hill ME, Richards MA, Gregory WM, Smith P, Rubens RD. Spinal cord compression in breast cancer: a review of 70 cases. Br J Cancer. 1993; 68(5): 969-973.
[7]	Moujaess E, Kourie HR, Ghosn M. Cancer patients and research during COVID-19 pandemic: A systematic review of current evidence. Crit Rev Oncol Hematol. 2020; 150: 102972.
[8]	Coles C.E., Aristei C., Bliss J., Boersma L., Brunt A.M., Chatterjee S. International guidelines on radiation therapy for breast cancer during the COVID-19 pandemic. Clin. Oncol. R Coll. Radiol. G B. 2020; 32(5): 279-281.
[9]	Ueda M., Martins R., Hendrie P.C., McDonnell T., Crews J.R., Wong T.L. Managing Cancer care during the COVID-19 pandemic: agility and collaboration toward a common goal. J. Natl. Compr. Cancer Netw. JNCCN. 2020; 20: 14.