tetano
Editor, Senior Moderator
Emerg Infect Dis
. 2020 Jun 2;26(9).
doi: 10.3201/eid2609.202122. Online ahead of print.
Encephalopathy and Encephalitis Associated With Cerebrospinal Fluid Cytokine Alterations and Coronavirus Disease, Atlanta, Georgia, USA, 2020
Karima Benameur, Ankita Agarwal, Sara C Auld, Matthew P Butters, Andrew S Webster, Tugba Ozturk, J Christina Howell, Leda C Bassit, Alvaro Velasquez, Raymond F Schinazi, Mark E Mullins, William T Hu
Abstract
There are few detailed investigations of neurologic complications in severe acute respiratory syndrome coronavirus 2 infection. We describe 3 patients with laboratory-confirmed coronavirus disease who development of encephalopathy and encephalitis. Neuroimaging showed nonenhancing unilateral, bilateral, and midline changes not readily attributable to vascular causes. All 3 patients had increased cerebrospinal fluid (CSF) levels of anti-S1 IgM. One patient who died also had increased levels of anti-envelope protein IgM. CSF analysis also showed markedly increased levels of interleukin (IL)-6, IL-8, and IL-10, but severe acute respiratory syndrome coronavirus 2 was not identified in any CSF sample. These changes provide evidence of CSF periinfectious/postinfectious inflammatory changes during coronavirus disease with neurologic complications.
Keywords: Atlanta; COVID-19; CSF; Georgia; SARS-CoV-2; United States; cerebrospinal fluid; coronavirus disease; coronaviruses; cytokines; encephalitis; encephalopathy; meningitis/encephalitis; respiratory infections; serologic analysis; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.
. 2020 Jun 2;26(9).
doi: 10.3201/eid2609.202122. Online ahead of print.
Encephalopathy and Encephalitis Associated With Cerebrospinal Fluid Cytokine Alterations and Coronavirus Disease, Atlanta, Georgia, USA, 2020
Karima Benameur, Ankita Agarwal, Sara C Auld, Matthew P Butters, Andrew S Webster, Tugba Ozturk, J Christina Howell, Leda C Bassit, Alvaro Velasquez, Raymond F Schinazi, Mark E Mullins, William T Hu
- PMID: 32487282
- DOI: 10.3201/eid2609.202122
Abstract
There are few detailed investigations of neurologic complications in severe acute respiratory syndrome coronavirus 2 infection. We describe 3 patients with laboratory-confirmed coronavirus disease who development of encephalopathy and encephalitis. Neuroimaging showed nonenhancing unilateral, bilateral, and midline changes not readily attributable to vascular causes. All 3 patients had increased cerebrospinal fluid (CSF) levels of anti-S1 IgM. One patient who died also had increased levels of anti-envelope protein IgM. CSF analysis also showed markedly increased levels of interleukin (IL)-6, IL-8, and IL-10, but severe acute respiratory syndrome coronavirus 2 was not identified in any CSF sample. These changes provide evidence of CSF periinfectious/postinfectious inflammatory changes during coronavirus disease with neurologic complications.
Keywords: Atlanta; COVID-19; CSF; Georgia; SARS-CoV-2; United States; cerebrospinal fluid; coronavirus disease; coronaviruses; cytokines; encephalitis; encephalopathy; meningitis/encephalitis; respiratory infections; serologic analysis; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.