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妊娠期新型冠状病毒 2019(COVID-19)患者合并神经系统症状时,其脑脊液中冠状病毒 2 的发生率。

Incidence of Coronavirus-2 in cerebrospinal fluid in pregnant Coronavirus Disease 2019 (COVID-19) patients with neurological symptoms.

机构信息

Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun University, Samsun, Turkey.

Department of Medical Microbiology, Samsun Training and Research Hospital, Samsun University, Samsun, Turkey.

出版信息

Indian J Pathol Microbiol. 2024 Jul 1;67(3):602-606. doi: 10.4103/ijpm.ijpm_72_23. Epub 2023 Nov 9.

DOI:10.4103/ijpm.ijpm_72_23
PMID:38394401
Abstract

BACKGROUND

The aim of this prospective cohort study was to investigate the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the cerebrospinal fluid (CSF) of pregnant women with neurological symptoms due to coronavirus disease 2019 (COVID-19).

MATERIALS AND METHODS

This research was carried out in the Samsun University. Department of Anesthesiology and Reanimation from December 2021 to May 2022. Pregnant women exhibiting neurological symptoms linked to COVID-19 were assigned to one of the two groups, depending on the severity of the disease-mild (Group 1) and severe (Group 2). Specimens were collected from patients' CSF, and the presence of SARS-CoV-2 was investigated using the reverse transcription-polymerase chain reaction (RT-PCR) method. SARS-CoV-2 was also investigated using RT-PCR by collecting oropharyngeal swab specimens from infants in the first 6 h after birth.

RESULTS

One hundred fifty patients were enrolled, 75 in both groups. The most frequent neurological symptoms were dizziness in Group 1 (52%) and headache in Group 2 (32%). No significant differences were determined in neutrophils, lymphocytes, hemoglobin, leukocytes, platelets, ferritin, D-dimer, C-reactive protein, prothrombin time, aspartate aminotransferase, alanine aminotransferase, creatinine, sedimentation, or fibrinogen values. SARS-CoV-2 was identified in the CSF of only one patient, from Group 2. Infant oropharyngeal swab specimens tested negative for SARS-CoV-2 using RT-PCR.

CONCLUSION

This study indicates that the detection of SARS-CoV-2 in CSF via RT-PCR is rare. We suggest that neurological symptoms linked to SARS-CoV-2 are not caused by direct invasion and that other etiologies represent more likely mechanisms.

摘要

背景

本前瞻性队列研究旨在调查患有与 2019 年冠状病毒病(COVID-19)相关的神经系统症状的孕妇的脑脊液(CSF)中是否存在严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)。

材料和方法

本研究于 2021 年 12 月至 2022 年 5 月在萨姆松大学麻醉与复苏系进行。患有与 COVID-19 相关的神经系统症状的孕妇根据疾病的严重程度分为两组:轻症(第 1 组)和重症(第 2 组)。采集患者的 CSF 标本,使用逆转录聚合酶链反应(RT-PCR)方法检测 SARS-CoV-2 的存在。通过采集婴儿出生后 6 小时内的口咽拭子标本,使用 RT-PCR 方法也对 SARS-CoV-2 进行了检测。

结果

共纳入 150 例患者,每组 75 例。第 1 组最常见的神经系统症状为头晕(52%),第 2 组为头痛(32%)。两组间中性粒细胞、淋巴细胞、血红蛋白、白细胞、血小板、铁蛋白、D-二聚体、C 反应蛋白、凝血酶原时间、天冬氨酸转氨酶、丙氨酸转氨酶、肌酐、沉降率或纤维蛋白原值无显著差异。仅在第 2 组的 1 例患者的 CSF 中检测到 SARS-CoV-2。使用 RT-PCR 对婴儿的口咽拭子标本进行检测,均为 SARS-CoV-2 阴性。

结论

本研究表明,通过 RT-PCR 检测 CSF 中 SARS-CoV-2 很少见。我们认为与 SARS-CoV-2 相关的神经系统症状不是由直接侵犯引起的,其他病因可能是更可能的机制。

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