以脑脊液炎症标志物升高为首发表现的急性脑病与 COVID-19。
Acute encephalopathy with elevated CSF inflammatory markers as the initial presentation of COVID-19.
机构信息
Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, 06510, USA.
Department of Neurology, Yale School of Medicine, New Haven, CT, 06510, USA.
出版信息
BMC Neurol. 2020 Jun 18;20(1):248. doi: 10.1186/s12883-020-01812-2.
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.
背景
COVID-19 是由严重急性呼吸系统综合症病毒 SARS-CoV-2 引起的。它被广泛认为是一种呼吸道病原体，但在一部分感染患者中，神经并发症可能是其首发表现。
病例介绍
我们描述了一例 78 岁免疫功能低下的女性，在家中目睹类似癫痫发作的活动后出现精神状态改变。她被发现感染了 SARS-CoV-2，且伴有神经炎症。在本病例中，我们首次对 COVID-19 感染期间的脑脊液（CSF）细胞因子进行了详细分析，发现 CSF 中有独特的炎症模式，但没有病毒侵犯中枢神经系统的证据。
结论
我们的发现表明，脑病和癫痫等神经系统症状可能是 COVID-19 的首发表现。中枢神经系统炎症可能与疾病的神经系统表现有关。
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