Status of SARS-CoV-2 in cerebrospinal fluid of patients with COVID-19 and stroke

Journal of Neurology, Neurosurgery and Psychiatry - Tập 91 Số 8 - Trang 846-848 - 2020
Fadi Al Saiegh1, Ritam Ghosh1, Adam Leibold1, Michael B. Avery1, Richard F. Schmidt1, Thana Theofanis1, Nikolaos Mouchtouris1, Lucas Philipp1, Stephen C. Peiper2, Zi-Xuan Wang3, Fred Rincón1, Stavropoula Tjoumakaris1, Pascal Jabbour1, Robert H. Rosenwasser1, M. Reid Gooch4
1Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
2Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
3Surgery & Pathology, Molecular & Genomic Pathology Laboratory, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
4Department of Neurological Surgery, Thomas Jefferson University, Philadelphia PA 19107, Pennsylvania, USA

Tóm tắt

BackgroundEmergence of the novel corona virus (severe acute respiratory syndrome (SARS)-CoV-2) in December 2019 has led to the COVID-19 pandemic. The extent of COVID-19 involvement in the central nervous system is not well established, and the presence or the absence of SARS-CoV-2 particles in the cerebrospinal fluid (CSF) is a topic of debate.Case descriptionWe present two patients with COVID-19 and concurrent neurological symptoms. Our first patient is a 31-year-old man who had flu-like symptoms due to COVID-19 and later developed an acute-onset severe headache and loss of consciousness and was diagnosed with a Hunt and Hess grade 3 subarachnoid haemorrhage from a ruptured aneurysm. Our second patient is a 62-year-old woman who had an ischaemic stroke with massive haemorrhagic conversion requiring a decompressive hemicraniectomy. Both patients’ CSF was repeatedly negative on real-time PCR analysis despite concurrent neurological disease.ConclusionOur report shows that patients’ CSF may be devoid of viral particles even when they test positive for COVID-19 on a nasal swab. Whether SARS-CoV-2 is present in CSF may depend on the systemic disease severity and the degree of the virus’ nervous tissue tropism and should be examined in future studies.

Từ khóa


Tài liệu tham khảo

Chen, 2020, [Advances in the research of cytokine storm mechanism induced by Corona Virus Disease 2019 and the corresponding immunotherapies], Zhonghua Shao Shang Za Zhi, 36

Moriguchi, 2020, A first case of meningitis/encephalitis associated with SARS-Coronavirus-2, Int J Infect Dis, 94, 55, 10.1016/j.ijid.2020.03.062

Li, 2020, The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients, J Med Virol

Poyiadji, 2020, COVID-19-associated acute hemorrhagic necrotizing encephalopathy: CT and MRI features, Radiology

Wu, 2020, Nervous system involvement after infection with COVID-19 and other coronaviruses, Brain Behav Immun

Zhou, 2020, A pneumonia outbreak associated with a new coronavirus of probable bat origin, Nature, 579, 270, 10.1038/s41586-020-2012-7

Ge, 2013, Isolation and characterization of a bat SARS-like coronavirus that uses the ACE2 receptor, Nature, 503, 535, 10.1038/nature12711

Xia, 2008, Angiotensin-Converting enzyme 2 in the brain: properties and future directions, J Neurochem, 107, 1482, 10.1111/j.1471-4159.2008.05723.x

Ding, 2003, The clinical pathology of severe acute respiratory syndrome (SARS): a report from China, J Pathol, 200, 282, 10.1002/path.1440

Hu, 2018, Genomic characterization and infectivity of a novel SARS-like coronavirus in Chinese bats, Emerg Microbes Infect, 7, 1, 10.1038/s41426-018-0155-5

Li, 2016, Middle East respiratory syndrome coronavirus causes multiple organ damage and lethal disease in mice transgenic for human dipeptidyl peptidase 4, J Infect Dis, 213, 712, 10.1093/infdis/jiv499

Mao L , Wang M , Chen S , et al . Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. SSRN Journal 2020.doi:10.2139/ssrn.3544840

Mehta, 2020, COVID-19: consider cytokine storm syndromes and immunosuppression, Lancet, 395, 1033, 10.1016/S0140-6736(20)30628-0

Driggin, 2020, Cardiovascular considerations for patients, health care workers, and health systems during the coronavirus disease 2019 (COVID-19) pandemic, J Am Coll Cardiol

Tang N , Bai H , Chen X , et al . Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost 2020.doi:10.1111/jth.14817

Zhang, 2020, Coagulopathy and antiphospholipid antibodies in patients with Covid-19, N Engl J Med, 10.1056/NEJMc2007575

Thông tin
Thông tin xuất bản

Journal of Neurology, Neurosurgery and Psychiatry

Tập 91 Số 8

846-848

Thông tin tác giả