Acute encephalopathy with elevated CSF inflammatory markers as the initial presentation of COVID-19

Background COVID-19 is caused by the severe acute respiratory syndrome virus SARS-CoV-2. It is widely recognized as a respiratory pathogen, but neurologic complications can be the presenting manifestation in a subset of infected patients. Case presentation We describe a 78-year old immunocompromised...

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Published in:BMC neurology Vol. 20; no. 1; pp. 248 - 5
Main Authors: Farhadian, Shelli, Glick, Laura R., Vogels, Chantal B. F., Thomas, Jared, Chiarella, Jennifer, Casanovas-Massana, Arnau, Zhou, Jing, Odio, Camila, Vijayakumar, Pavithra, Geng, Bertie, Fournier, John, Bermejo, Santos, Fauver, Joseph R., Alpert, Tara, Wyllie, Anne L., Turcotte, Cynthia, Steinle, Matthew, Paczkowski, Patrick, Dela Cruz, Charles, Wilen, Craig, Ko, Albert I., MacKay, Sean, Grubaugh, Nathan D., Spudich, Serena, Barakat, Lydia Aoun
Format: Journal Article
Language:English
Published: London BioMed Central 18.06.2020
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
Acute Disease
Age
Aged
Betacoronavirus
Biomarkers - cerebrospinal fluid
Blood
Case Report
Central nervous system
Cerebrospinal fluid
Coronavirus Infections
Coronaviruses
COVID-19
Cytokines
Cytokines - cerebrospinal fluid
Diagnosis
Disease
Encephalitis, Viral
Encephalopathy
Female
Health aspects
Hospitals
Humans
Illnesses
Infections
Inflammation
Invasiveness
Laboratories
Magnetic resonance imaging
Medicine
Medicine & Public Health
Metabolism
Nervous system
Neurochemistry
Neurocritical care
Neuroinflammation
Neurological complications
Neurology
Neurosurgery
Pandemics
Patients
Plasma
Pneumonia, Viral
Proteins
SARS-CoV-2
Seizures
Seizures (Medicine)
Severe acute respiratory syndrome
Severe acute respiratory syndrome coronavirus 2
China
COVID-19
Neuroinflammation
SARS-CoV-2
ISSN:1471-2377, 1471-2377
Online Access:Get full text
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Summary:Background COVID-19 is caused by the severe acute respiratory syndrome virus SARS-CoV-2. It is widely recognized as a respiratory pathogen, but neurologic complications can be the presenting manifestation in a subset of infected patients. Case presentation We describe a 78-year old immunocompromised woman who presented with altered mental status after witnessed seizure-like activity at home. She was found to have SARS-CoV-2 infection and associated neuroinflammation. In this case, we undertake the first detailed analysis of cerebrospinal fluid (CSF) cytokines during COVID-19 infection and find a unique pattern of inflammation in CSF, but no evidence of viral neuroinvasion. Conclusion Our findings suggest that neurologic symptoms such as encephalopathy and seizures may be the initial presentation of COVID-19. Central nervous system inflammation may associate with neurologic manifestations of disease.
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ISSN:1471-2377
1471-2377
DOI:10.1186/s12883-020-01812-2