Spinal cord medicine today: Meeting the challenges of pandemic-era research and care

Every aspect of society has been affected by the COVID-19 pandemic, with the greatest stresses on health care systems worldwide. As the pandemic unfolded, many of JSCM’s reviewers assumed additional clinical duties as COVID-19 complicated the care of their patients with spinal cord injury. Many existing research studies had to be paused for safety reasons, while an abundance of new questions arose regarding the effects of infection, social isolation, and limited access to care in this population.

The impact was felt in the publishing world as well. While some journals experienced declines in submissions, an unprecedented number of manuscripts poured into the Journal of Spinal Cord Medicine. Recognizing the potential for higher risk in vulnerable populations, spinal cord injury professionals maintained a scholarly perspective and stepped up to close the knowledge gap.¹ During 2021, authors from Spain, the US, the UK, Canada, Japan, and India published their COVID-19-related research in the Journal.

Topics addressed secondary effects of the pandemic on physical activity, mental health, and health-related quality of life of individuals with spinal cord injury.^2–6 A review by researchers in India examined early reports of neurological deficits linked to COVID-19 infection.⁷ Two articles ranked among JSCM’s top ten downloads,^2,3 including at number one, the article documenting the negative impact of lockdowns on self-reported physical activity of full-time manual wheelchair users by researchers in Spain.² This was followed by a case series of COVID-19 infection in veterans with spinal cord injury in New York City, which showed that the most reliable predictors of severe infection were the presence of comorbid conditions, as in the general population.³

Taking advantage of time that had been reserved for studies paused by pandemic restrictions, clinician scientists at Toronto Rehab Institute in Canada focused on evaluating and synthesizing published research in the field of spinal cord injury rehabilitation. Their article details a ten-step guide for conducting rigorous systematic reviews in rehabilitation science, aimed at improving the quality of evidence and informing recommendations for clinical practice.⁸

The need to maintain a scholarly perspective remains paramount, as the impact of pandemic disruptions continues to be felt, and care guidelines expand to encompass vaccines and new treatments. There is still much to be learned about ensuring the safety of the population with spinal cord injury and the care and follow up of individuals with COVID-19 infection. JSCM will continue to help clinicians and researchers meet the challenges of the pandemic era by sharing their findings with the global community of professionals dedicated to improving the lives of people with injuries and dysfunction of the spinal cord.