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Status of SARS-CoV-2 in cerebrospinal fluid of patients with COVID-19 and stroke.
Al Saiegh, Fadi; Ghosh, Ritam; Leibold, Adam; Avery, Michael B; Schmidt, Richard F; Theofanis, Thana; Mouchtouris, Nikolaos; Philipp, Lucas; Peiper, Stephen C; Wang, Zi-Xuan; Rincon, Fred; Tjoumakaris, Stavropoula I; Jabbour, Pascal; Rosenwasser, Robert H; Gooch, M Reid.
  • Al Saiegh F; Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Ghosh R; Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Leibold A; Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Avery MB; Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Schmidt RF; Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Theofanis T; Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Mouchtouris N; Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Philipp L; Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Peiper SC; Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
  • Wang ZX; Surgery & Pathology, Molecular & Genomic Pathology Laboratory, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
  • Rincon F; Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Tjoumakaris SI; Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Jabbour P; Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Rosenwasser RH; Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Gooch MR; Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA reid.gooch@jefferson.edu.
J Neurol Neurosurg Psychiatry ; 91(8): 846-848, 2020 08.
Article in English | MEDLINE | ID: covidwho-154812
Semantic information from SemMedBD (by NLM)
1. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Cerebrospinal Fluid PART_OF Patients
Subject
Cerebrospinal Fluid
Predicate
PART_OF
Object
Patients
4. Severe Acute Respiratory Syndrome CAUSES COVID-19
Subject
Severe Acute Respiratory Syndrome
Predicate
CAUSES
Object
COVID-19
5. Neurologic Symptoms PROCESS_OF Patients
Subject
Neurologic Symptoms
Predicate
PROCESS_OF
Object
Patients
6. headache severe PROCESS_OF Male population group
Subject
headache severe
Predicate
PROCESS_OF
Object
Male population group
7. COVID-19 CAUSES Influenza-like symptoms
Subject
COVID-19
Predicate
CAUSES
Object
Influenza-like symptoms
8. Influenza-like symptoms PROCESS_OF Male population group
Subject
Influenza-like symptoms
Predicate
PROCESS_OF
Object
Male population group
9. Ischemic stroke PROCESS_OF Woman
Subject
Ischemic stroke
Predicate
PROCESS_OF
Object
Woman
10. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
11. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
12. Cerebrospinal Fluid PART_OF Patients
Subject
Cerebrospinal Fluid
Predicate
PART_OF
Object
Patients
13. Severe Acute Respiratory Syndrome CAUSES COVID-19
Subject
Severe Acute Respiratory Syndrome
Predicate
CAUSES
Object
COVID-19
14. Neurologic Symptoms PROCESS_OF Patients
Subject
Neurologic Symptoms
Predicate
PROCESS_OF
Object
Patients
15. headache severe PROCESS_OF Male population group
Subject
headache severe
Predicate
PROCESS_OF
Object
Male population group
16. COVID-19 CAUSES Influenza-like symptoms
Subject
COVID-19
Predicate
CAUSES
Object
Influenza-like symptoms
17. Influenza-like symptoms PROCESS_OF Male population group
Subject
Influenza-like symptoms
Predicate
PROCESS_OF
Object
Male population group
18. Ischemic stroke PROCESS_OF Woman
Subject
Ischemic stroke
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PROCESS_OF
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Woman
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)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Stroke / Betacoronavirus Type of study: Case report Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: J Neurol Neurosurg Psychiatry Year: 2020 Document Type: Article Affiliation country: Jnnp-2020-323522

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Stroke / Betacoronavirus Type of study: Case report Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: J Neurol Neurosurg Psychiatry Year: 2020 Document Type: Article Affiliation country: Jnnp-2020-323522