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Acute encephalopathy with elevated CSF inflammatory markers as the initial presentation of COVID-19.
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.
  • Farhadian S; Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, 06510, USA. shelli.farhadian@yale.edu.
  • Glick LR; Department of Neurology, Yale School of Medicine, New Haven, CT, 06510, USA. shelli.farhadian@yale.edu.
  • Vogels CBF; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06510, USA.
  • Thomas J; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA.
  • Chiarella J; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06510, USA.
  • Casanovas-Massana A; Department of Neurology, Yale School of Medicine, New Haven, CT, 06510, USA.
  • Zhou J; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA.
  • Odio C; Isoplexis, Branford, CT, 06540, USA.
  • Vijayakumar P; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06510, USA.
  • Geng B; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06510, USA.
  • Fournier J; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06510, USA.
  • Bermejo S; Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, 06510, USA.
  • Fauver JR; Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, 06510, USA.
  • Alpert T; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA.
  • Wyllie AL; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA.
  • Turcotte C; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA.
  • Steinle M; Isoplexis, Branford, CT, 06540, USA.
  • Paczkowski P; Isoplexis, Branford, CT, 06540, USA.
  • Dela Cruz C; Isoplexis, Branford, CT, 06540, USA.
  • Wilen C; Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, 06510, USA.
  • Ko AI; Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, 06510, USA.
  • MacKay S; Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, 06510, USA.
  • Grubaugh ND; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA.
  • Spudich S; Isoplexis, Branford, CT, 06540, USA.
  • Barakat LA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA.
BMC Neurol ; 20(1): 248, 2020 Jun 18.
Article in English | MEDLINE | ID: covidwho-603847
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This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
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ABSTRACT

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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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Cytokines / Coronavirus Infections / Encephalitis, Viral / Pandemics / Betacoronavirus Type of study: Case report / Prognostic study Limits: Aged / Female / Humans Language: English Journal: BMC Neurol Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: S12883-020-01812-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Cytokines / Coronavirus Infections / Encephalitis, Viral / Pandemics / Betacoronavirus Type of study: Case report / Prognostic study Limits: Aged / Female / Humans Language: English Journal: BMC Neurol Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: S12883-020-01812-2