Acute encephalopathy with elevated CSF inflammatory markers as the initial presentation of COVID-19.
COVID-19
SARS-CoV-2
neuroinflammation
Journal
Research square
Titre abrégé: Res Sq
Pays: United States
ID NLM: 101768035
Informations de publication
Date de publication:
12 May 2020
12 May 2020
Historique:
entrez:
24
7
2020
pubmed:
24
7
2020
medline:
24
7
2020
Statut:
epublish
Résumé
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. 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. 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.
Sections du résumé
BACKGROUND
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
METHODS
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
CONCLUSIONS
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.
Identifiants
pubmed: 32702723
doi: 10.21203/rs.3.rs-28583/v1
pmc: PMC7336693
pii:
doi:
Types de publication
Preprint
Langues
eng
Subventions
Organisme : NCATS NIH HHS
ID : TL1 TR001864
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Commentaires et corrections
Type : UpdateIn
Déclaration de conflit d'intérêts
Competing interests: the authors report no competing interests
Références
Radiology. 2020 Aug;296(2):E119-E120
pubmed: 32228363
J Virol. 2008 Aug;82(15):7264-75
pubmed: 18495771
Clin Infect Dis. 2005 Oct 15;41(8):1089-96
pubmed: 16163626
N Engl J Med. 2020 Jun 4;382(23):2268-2270
pubmed: 32294339
Int J Infect Dis. 2020 May;94:55-58
pubmed: 32251791
Infection. 2015 Aug;43(4):495-501
pubmed: 25600929
JAMA Neurol. 2020 Jun 1;77(6):683-690
pubmed: 32275288