tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2020 Oct 18;7(11)
faa501.
doi: 10.1093/ofid/ofaa501. eCollection 2020 Nov.
Cerebrospinal Analysis in Patients With COVID-19
Emily Happy Miller[SUP] 1 [/SUP], Vivian S Namale[SUP] 2 [/SUP], Carla Kim[SUP] 2 [/SUP], Rachelle Dugue[SUP] 2 [/SUP], Greer Waldrop[SUP] 2 [/SUP], Prajwal Ciryam[SUP] 2 [/SUP], Alexander M Chong[SUP] 1 [/SUP], Jason Zucker[SUP] 1 [/SUP], Eliza C Miller[SUP] 2 [/SUP], Jennifer M Bain[SUP] 2 [/SUP], Joshua Z Willey[SUP] 2 [/SUP], Kevin Doyle[SUP] 2 [/SUP], Amelia Boehme[SUP] 2 [/SUP], Jan Claassen[SUP] 2 [/SUP], Anne-Catrin Uhlemann[SUP] 1 [/SUP], Kiran T Thakur[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Assessment of the impact of cerebrospinal fluid (CSF) analysis including investigation for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for the optimization of patient care.
Methods: In this case series, we review patients diagnosed with SARS-CoV-2 undergoing lumbar puncture (LP) admitted to Columbia University Irving Medical Center (New York, NY, USA) from March 1 to May 26, 2020. In a subset of patients, CSF SARS-CoV-2 quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) testing is performed.
Results: The average age of 27 patients who underwent LP with definitive SARS-CoV-2 (SD) was 37.5 (28.7) years. CSF profiles showed elevated white blood cell counts and protein in 44% and 52% of patients, respectively. LP results impacted treatment decisions in 10 (37%) patients, either by change of antibiotics, influence in disposition decision, or by providing an alternative diagnosis. CSF SARS-CoV-2 qRT-PCR was performed on 8 (30%) patients, with negative results in all samples.
Conclusions: Among patients diagnosed with SARS-CoV-2, CSF results changed treatment decisions or disposition in over one-third of our patient cohort. CSF was frequently abnormal, though CSF SARS-CoV-2 qRT-PCR was negative in all samples. Further studies are required to define whether CSF SARS-CoV-2 testing is warranted in certain clinical contexts.
Keywords: SARS-CoV-2; cerebrospinal fluid (CSF); lumbar puncture; neuroinvasion.
. 2020 Oct 18;7(11)
faa501.doi: 10.1093/ofid/ofaa501. eCollection 2020 Nov.
Cerebrospinal Analysis in Patients With COVID-19
Emily Happy Miller[SUP] 1 [/SUP], Vivian S Namale[SUP] 2 [/SUP], Carla Kim[SUP] 2 [/SUP], Rachelle Dugue[SUP] 2 [/SUP], Greer Waldrop[SUP] 2 [/SUP], Prajwal Ciryam[SUP] 2 [/SUP], Alexander M Chong[SUP] 1 [/SUP], Jason Zucker[SUP] 1 [/SUP], Eliza C Miller[SUP] 2 [/SUP], Jennifer M Bain[SUP] 2 [/SUP], Joshua Z Willey[SUP] 2 [/SUP], Kevin Doyle[SUP] 2 [/SUP], Amelia Boehme[SUP] 2 [/SUP], Jan Claassen[SUP] 2 [/SUP], Anne-Catrin Uhlemann[SUP] 1 [/SUP], Kiran T Thakur[SUP] 2 [/SUP]
Affiliations
- PMID: 33230485
- PMCID: PMC7665724
- DOI: 10.1093/ofid/ofaa501
Abstract
Background: Assessment of the impact of cerebrospinal fluid (CSF) analysis including investigation for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for the optimization of patient care.
Methods: In this case series, we review patients diagnosed with SARS-CoV-2 undergoing lumbar puncture (LP) admitted to Columbia University Irving Medical Center (New York, NY, USA) from March 1 to May 26, 2020. In a subset of patients, CSF SARS-CoV-2 quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) testing is performed.
Results: The average age of 27 patients who underwent LP with definitive SARS-CoV-2 (SD) was 37.5 (28.7) years. CSF profiles showed elevated white blood cell counts and protein in 44% and 52% of patients, respectively. LP results impacted treatment decisions in 10 (37%) patients, either by change of antibiotics, influence in disposition decision, or by providing an alternative diagnosis. CSF SARS-CoV-2 qRT-PCR was performed on 8 (30%) patients, with negative results in all samples.
Conclusions: Among patients diagnosed with SARS-CoV-2, CSF results changed treatment decisions or disposition in over one-third of our patient cohort. CSF was frequently abnormal, though CSF SARS-CoV-2 qRT-PCR was negative in all samples. Further studies are required to define whether CSF SARS-CoV-2 testing is warranted in certain clinical contexts.
Keywords: SARS-CoV-2; cerebrospinal fluid (CSF); lumbar puncture; neuroinvasion.