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Acute necrotizing e...
Acute necrotizing encephalopathy with SARS-CoV-2 RNA confirmed in cerebrospinal fluid
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- Virhammar, Johan (author)
- Uppsala universitet,Landtblom: Neurovetenskap
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- Kumlien, Eva (author)
- Uppsala universitet,Landtblom: Neurovetenskap
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- Fällmar, David (author)
- Uppsala universitet,Radiologi
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- Frithiof, Robert (author)
- Karolinska Institutet,Uppsala universitet,Anestesiologi och intensivvård
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- Jackmann, Sven (author)
- Uppsala universitet,Landtblom: Neurovetenskap
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- Sköld, Mattias K. (author)
- Uppsala universitet,Enblad: Neurokirurgi
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Kadir, Mohamed (author)
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Frick, Jens (author)
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Lindeberg, Jonas (author)
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- Olivero-Reinius, Henrik, 1968- (author)
- Uppsala universitet,Anestesiologi och intensivvård
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- Ryttlefors, Mats (author)
- Uppsala universitet,Enblad: Neurokirurgi
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- Cunningham, Janet L. (author)
- Uppsala universitet,Ekselius: Psykiatri
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- Wikström, Johan, 1964- (author)
- Uppsala universitet,Radiologi
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- Grabowska, Anna (author)
- Uppsala universitet,Radiologi
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- Bondeson, Kåre, 1960- (author)
- Uppsala universitet,Infektionsmedicin
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- Bergquist, Jonas (author)
- Uppsala universitet,Analytisk kemi
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Zetterberg, Henrik (author)
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- Rostami, Elham, 1979- (author)
- Karolinska Institutet,Uppsala universitet,Enblad: Neurokirurgi
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(creator_code:org_t)
- 2020
- 2020
- English.
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In: Neurology. - 0028-3878 .- 1526-632X. ; 95:10, s. 445-449
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https://uu.diva-port... (primary) (Raw object)
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Abstract
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- Here, we report a case of COVID-19–related acute necrotizing encephalopathy where SARS-CoV-2 RNA was found in CSF 19 days after symptom onset after testing negative twice. Although monocytes and protein levels in CSF were only marginally increased, and our patient never experienced a hyperinflammatory state, her neurologic function deteriorated into coma. MRI of the brain showed pathologic signal symmetrically in central thalami, subinsular regions, medial temporal lobes, and brain stem. Extremely high concentrations of the neuronal injury markers neurofilament light and tau, as well as an astrocytic activation marker, glial fibrillary acidic protein, were measured in CSF. Neuronal rescue proteins and other pathways were elevated in the in-depth proteomics analysis. The patient received IV immunoglobulins and plasma exchange. Her neurologic status improved, and she was extubated 4 weeks after symptom onset. This case report highlights the neurotropism of SARS-CoV-2 in selected patients and emphasizes the importance of repeated lumbar punctures and CSF analyses in patients with suspected COVID-19 and neurologic symptoms.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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Neurology
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To the university's database
- By the author/editor
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Virhammar, Johan
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Kumlien, Eva
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Fällmar, David
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Frithiof, Robert
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Jackmann, Sven
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Sköld, Mattias K ...
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show more...
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Kadir, Mohamed
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Frick, Jens
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Lindeberg, Jonas
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Olivero-Reinius, ...
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Ryttlefors, Mats
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Cunningham, Jane ...
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Wikström, Johan, ...
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Grabowska, Anna
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Bondeson, Kåre, ...
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Bergquist, Jonas
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Zetterberg, Henr ...
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Rostami, Elham, ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Infectious Medic ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
- Articles in the publication
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Neurology
- By the university
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Uppsala University
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Karolinska Institutet