Encephalopathy and Encephalitis Associated with Cerebrospinal Fluid Cytokine Alterations and Coronavirus Disease, Atlanta, Georgia, USA, 2020

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

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 had encephalopathy and encephalitis develop. 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.

2020

Viruses, Coronaviruses, covid-19, severe acute respiratory syndrome coronavirus 2, coronavirus disease, SARA-CoV-2

10.3201/eid2609.202122

Emerging Infectious Diseases

Centers for Disease Control and Prevention

Medicine, Infectious and parasitic diseases