Cerebrospinal Analysis in Patients With COVID-19. (18th October 2020)

• Record Type: Journal Article
• Authors: Miller, Emily Happy; Namale, Vivian S; Kim, Carla; Dugue, Rachelle; Waldrop, Greer; Ciryam, Prajwal; Chong, Alexander M; Zucker, Jason; Miller, Eliza C; Bain, Jennifer M; Willey, Joshua Z; Doyle, Kevin; Boehme, Amelia; Claassen, Jan; Uhlemann, Anne-Catrin; Thakur, Kiran T
• Is Part Of: Open forum infectious diseases. Volume 7:Number 11(2020)
• Publication Date: 2020-10-18
• Subjects: cerebrospinal fluid (CSF) -- lumbar puncture -- neuroinvasion -- SARS-CoV-2; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofaa501
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Assessment of the impact of cerebrospinal fluid (CSF) analysis including investigation for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for the optimization of patient care. Methods: In this case series, we review patients diagnosed with SARS-CoV-2 undergoing lumbar puncture (LP) admitted to Columbia University Irving Medical Center (New York, NY, USA) from March 1 to May 26, 2020. In a subset of patients, CSF SARS-CoV-2 quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) testing is performed. Results: The average age of 27 patients who underwent LP with definitive SARS-CoV-2 (SD) was 37.5 (28.7) years. CSF profiles showed elevated white blood cell counts and protein in 44% and 52% of patients, respectively. LP results impacted treatment decisions in 10 (37%) patients, either by change of antibiotics, influence in disposition decision, or by providing an alternative diagnosis. CSF SARS-CoV-2 qRT-PCR was performed on 8 (30%) patients, with negative results in all samples. Conclusions: Among patients diagnosed with SARS-CoV-2, CSF results changed treatment decisions or disposition in over one-third of our patient cohort. CSF was frequently abnormal, though CSF SARS-CoV-2 qRT-PCR was negative in all samples. Further studies are required to define whether CSF SARS-CoV-2 testing is warranted in certain clinical contexts.