Cerebrospinal fluid analysis in patients with COVID-19-associated central nervous system manifestations: a systematic review
ABSTRACT Background: Central nervous system (CNS) symptoms may occur in patients with acute COVID-19. The role of CSF examination in these patients remains to be established. Objective: A systematic review of CSF findings relating to COVID-19 was carried out. Methods: CSF parameters, including cy...
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Thieme Revinter Publicações
2022-02-01
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| Series: | Arquivos de Neuro-Psiquiatria |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2022005004205&tlng=en |
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| author | Renan Barros Domingues Fernando Brunale Vilela de Moura Leite Carlos Senne |
| author_facet | Renan Barros Domingues Fernando Brunale Vilela de Moura Leite Carlos Senne |
| author_sort | Renan Barros Domingues |
| collection | DOAJ |
| description | ABSTRACT Background: Central nervous system (CNS) symptoms may occur in patients with acute COVID-19. The role of CSF examination in these patients remains to be established. Objective: A systematic review of CSF findings relating to COVID-19 was carried out. Methods: CSF parameters, including cytological and biochemical analyses, SARS-CoV-2 RT-PCR and other CSF markers, were recorded and analyzed among patients with acute COVID-19 and one of the following CNS syndromes: stroke, encephalopathy, encephalitis, inflammatory syndromes, seizure, headache and meningitis. Results: Increased white blood cells and/or increased protein concentration were found in 52.7% of the patients with encephalitis, 29.4% of the patients with encephalopathy and 46.7% of the patients with inflammatory syndromes (P < 0.05). CSF RT-PCR for SARS-CoV-2 was positive in 17.35% of the patients with encephalitis and less than 3.5% of the patients with encephalopathy or inflammatory syndromes (P < 0.05). Intrathecal production of immunoglobulins was found in only 8% of the cases. More than 85% of the patients had increased CSF cytokines and chemokines. Increased CSF neurofilament light chain (NfL) and CSF Tau were found in 71% and 36% of the cases, respectively. Conclusion: Non-specific inflammatory CSF abnormalities were frequently found in patients with COVID-19 CNS syndromes. The increase in neurodegeneration biomarkers suggests that neuronal damage occurs, with long-term consequences that are still unknown. |
| format | Article |
| id | doaj-art-de9eb2b87bdf4c9d8dee39fdb5d09a7c |
| institution | OA Journals |
| issn | 1678-4227 |
| language | English |
| publishDate | 2022-02-01 |
| publisher | Thieme Revinter Publicações |
| record_format | Article |
| series | Arquivos de Neuro-Psiquiatria |
| spelling | doaj-art-de9eb2b87bdf4c9d8dee39fdb5d09a7c2025-08-20T02:21:21ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-42272022-02-0110.1590/0004-282x-anp-2021-0117Cerebrospinal fluid analysis in patients with COVID-19-associated central nervous system manifestations: a systematic reviewRenan Barros Domingueshttps://orcid.org/0000-0002-6058-7937Fernando Brunale Vilela de Moura Leitehttps://orcid.org/0000-0003-2661-1523Carlos Sennehttps://orcid.org/0000-0002-8056-1064ABSTRACT Background: Central nervous system (CNS) symptoms may occur in patients with acute COVID-19. The role of CSF examination in these patients remains to be established. Objective: A systematic review of CSF findings relating to COVID-19 was carried out. Methods: CSF parameters, including cytological and biochemical analyses, SARS-CoV-2 RT-PCR and other CSF markers, were recorded and analyzed among patients with acute COVID-19 and one of the following CNS syndromes: stroke, encephalopathy, encephalitis, inflammatory syndromes, seizure, headache and meningitis. Results: Increased white blood cells and/or increased protein concentration were found in 52.7% of the patients with encephalitis, 29.4% of the patients with encephalopathy and 46.7% of the patients with inflammatory syndromes (P < 0.05). CSF RT-PCR for SARS-CoV-2 was positive in 17.35% of the patients with encephalitis and less than 3.5% of the patients with encephalopathy or inflammatory syndromes (P < 0.05). Intrathecal production of immunoglobulins was found in only 8% of the cases. More than 85% of the patients had increased CSF cytokines and chemokines. Increased CSF neurofilament light chain (NfL) and CSF Tau were found in 71% and 36% of the cases, respectively. Conclusion: Non-specific inflammatory CSF abnormalities were frequently found in patients with COVID-19 CNS syndromes. The increase in neurodegeneration biomarkers suggests that neuronal damage occurs, with long-term consequences that are still unknown.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2022005004205&tlng=enCOVID-19Cerebrospinal FluidEncephalitisPolymerase Chain ReactionHeadache |
| spellingShingle | Renan Barros Domingues Fernando Brunale Vilela de Moura Leite Carlos Senne Cerebrospinal fluid analysis in patients with COVID-19-associated central nervous system manifestations: a systematic review Arquivos de Neuro-Psiquiatria COVID-19 Cerebrospinal Fluid Encephalitis Polymerase Chain Reaction Headache |
| title | Cerebrospinal fluid analysis in patients with COVID-19-associated central nervous system manifestations: a systematic review |
| title_full | Cerebrospinal fluid analysis in patients with COVID-19-associated central nervous system manifestations: a systematic review |
| title_fullStr | Cerebrospinal fluid analysis in patients with COVID-19-associated central nervous system manifestations: a systematic review |
| title_full_unstemmed | Cerebrospinal fluid analysis in patients with COVID-19-associated central nervous system manifestations: a systematic review |
| title_short | Cerebrospinal fluid analysis in patients with COVID-19-associated central nervous system manifestations: a systematic review |
| title_sort | cerebrospinal fluid analysis in patients with covid 19 associated central nervous system manifestations a systematic review |
| topic | COVID-19 Cerebrospinal Fluid Encephalitis Polymerase Chain Reaction Headache |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2022005004205&tlng=en |
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