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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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; and Barakat, Lydia Aoun, "Acute Encephalopathy With Elevated CSF Inflammatory Markers as the Initial Presentation of COVID-19" (2020). Journal Articles: Epidemiology. 73.