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J Neurol Neurosurg Psychiatry ; 91(8): 846-848, 2020 08.
Article in English | MEDLINE | ID: covidwho-154812

ABSTRACT

BACKGROUND: Emergence 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 DESCRIPTION: We 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. CONCLUSION: Our 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.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/cerebrospinal fluid , Coronavirus Infections/complications , Pneumonia, Viral/cerebrospinal fluid , Pneumonia, Viral/complications , Stroke/complications , Stroke/virology , Adult , COVID-19 , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Stroke/cerebrospinal fluid
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