As we continue to grapple with the SAR-CoV2 pandemic, we are discovering various non-pulmonary complications of the virus. Studies have documented that the SARS-CoV2 virus impacts many other organ systems, such as the heart bone marrow, kidneyiver, brain, and other organs.However, no orthopedic complications have been reported.  

In the adult population, the most common cause of non-traumatic atlantoaxial subluxation is rheumatoid arthritis.  However, there are also several reported cases of upper respiratory tract infections causing atlantoaxial subluxation in adults. Currently, there are two mechanisms which help describe their association. Firstly, severe pharyngeal inflammation extends to the parapharyngeal space and then to the transverse ligament of the atlas. The inflammation weakens the transverse ligament causing subluxation. In the second mechanism, the infection accesses the atlantoaxial joint through a hematogenous routeAlthough COVID-19 also causes severe inflammation and accesses the bloodstream, no cases of atlantoaxial subluxation secondary to the COVID-19 virus have been described. 

In this cases, we describe healthy elderly males who suffered from atlantoaxial subluxation shortly after a mild COVID-19 infection. Further studies are required to further understand its efficacy and role in the COVID-19 as an inflammatory cause of atlantoaxial subluxation.