A Comprehensive Systematic Review of CSF analysis that defines Neurological Manifestations of COVID-19.

Abstract

BACKGROUND:

Limited literature exists on Cerebrospinal fluid (CSF) findings in COVID-19 patients with neurological symptoms. In this review, we conducted a descriptive analysis of CSF findings in patients with COVID-19 to understand prognosis and explore therapeutic options.

METHODS:

We searched PubMed, Google Scholar, and Scopus databases using the keywords "SARS-CoV-2 in cerebrospinal fluid" and "SARS-CoV-2 and CNS Complications"" for reports of CSF findings in COVID-19 related neurological manifestations. Descriptive analyses were conducted to observe the CSF protein and cell counts based on age, gender, severity, fatality of COVID-19, and whether central (CNS) or peripheral nervous system (PNS) was associated.

RESULTS:

A total of 113 patients were identified from 67 studies. Of these, 7 patients (6.2%) were fatal COVID-19 cases and 35 patients (31%) were considered severe COVID-19 cases. CSF protein was elevated in 100% (7/7) of the fatal cases with an average of 61.28 mg/dl and in 65.0% (52/80) in non-fatal cases with an average 56.73 mg/dl. CSF protein levels were elevated in 74.5% (38/51) patients with non-severe COVID-19 and 68.6% (24/35) in those with a severe COVID-19 infection. CSF cell count was increased in 43% of fatal cases, 25.7% severe cases, and 29.4% of non-severe cases.

CONCLUSION:

Our analysis showed that the most common CSF findings situation in COVID-19 infection is elevated protein with, very occasionally, mild lymphocyte predominant pleocytosis. Further studies to elucidate the pathophysiology of neurological complications in COVID-19 are recommended.

• Authors: Medha Tandon, Saurabh Kataria, Jenil Patel, Tejas R Mehta, Maha Daimee, Viral Patel, Apoorv Prasad, Anisa Anila Chowdhary, Shruti Jaiswal, Shitiz Sriwastava
• Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (Int J Infect Dis) Vol. 104 Pg. 390-397 (Mar 2021) ISSN: 1878-3511 [Electronic] Canada
• PMID: 33434662 (Publication Type: Journal Article, Systematic Review)
• Copyright: Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Topics

• COVID-19 (cerebrospinal fluid, complications, virology)
• Humans
• Leukocytosis (cerebrospinal fluid, etiology)
• Nervous System Diseases (cerebrospinal fluid, etiology)
• SARS-CoV-2 (physiology)