Spectrum of neurological manifestations and systematic evaluation of cerebrospinal fluid for SARS-CoV2 in patients admitted to hospital during the COVID-19 epidemic in South Africa
Abstract Neurological manifestations of COVID-19 are increasingly described in the literature. There is uncertainty whether these occur due to direct neuroinvasion of the virus, para-infectious immunopathology, as result of systemic complications of disease such as hypercoagulability or due to a combination of these mechanisms. Here we describe clinical and radiological manifestations in a sequential cohort of patients presenting to a district hospital in South Africa with neurological symptoms with and without confirmed COVID-19 during the first peak of the epidemic. In these patients, where symptoms suggestive of meningitis and encephalitis were most common, thorough assessment of presence in CSF via PCR for SARS-CoV2 did not explain neurological presentations, notwithstanding very high rates of COVID-19 admissions. Although an understanding of potential neurotropic mechanisms remains an important area of research, these results provide rationale for greater focus towards the understanding of para-immune pathogenic processes and the contribution of systemic coagulopathy and their interaction with pre-existing risk factors in order to better manage neurological disease in the context of COVID-19. These results also inform the clinician that consideration of an alternative diagnosis and treatment for neurological presentations in this context is crucial, even in the patient with a confirmed diagnosis COVID-19..
Medienart: |
Preprint |
---|
Erscheinungsjahr: |
2021 |
---|---|
Erschienen: |
2021 |
Enthalten in: |
bioRxiv.org - (2021) vom: 21. Mai Zur Gesamtaufnahme - year:2021 |
---|
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Davis, Angharad G [VerfasserIn] |
---|
Links: |
Volltext [kostenfrei] |
---|
doi: |
10.1101/2021.05.14.21254691 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
XBI020603258 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | XBI020603258 | ||
003 | DE-627 | ||
005 | 20230429100225.0 | ||
007 | cr uuu---uuuuu | ||
008 | 210521s2021 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1101/2021.05.14.21254691 |2 doi | |
035 | |a (DE-627)XBI020603258 | ||
035 | |a (DE-599)biorXiv10.1101/2021.05.14.21254691 | ||
035 | |a (biorXiv)10.1101/2021.05.14.21254691 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
082 | 0 | |a 570 |q DE-84 | |
100 | 1 | |a Davis, Angharad G |e verfasserin |4 aut | |
245 | 1 | 0 | |a Spectrum of neurological manifestations and systematic evaluation of cerebrospinal fluid for SARS-CoV2 in patients admitted to hospital during the COVID-19 epidemic in South Africa |
264 | 1 | |c 2021 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a Computermedien |b c |2 rdamedia | ||
338 | |a Online-Ressource |b cr |2 rdacarrier | ||
520 | |a Abstract Neurological manifestations of COVID-19 are increasingly described in the literature. There is uncertainty whether these occur due to direct neuroinvasion of the virus, para-infectious immunopathology, as result of systemic complications of disease such as hypercoagulability or due to a combination of these mechanisms. Here we describe clinical and radiological manifestations in a sequential cohort of patients presenting to a district hospital in South Africa with neurological symptoms with and without confirmed COVID-19 during the first peak of the epidemic. In these patients, where symptoms suggestive of meningitis and encephalitis were most common, thorough assessment of presence in CSF via PCR for SARS-CoV2 did not explain neurological presentations, notwithstanding very high rates of COVID-19 admissions. Although an understanding of potential neurotropic mechanisms remains an important area of research, these results provide rationale for greater focus towards the understanding of para-immune pathogenic processes and the contribution of systemic coagulopathy and their interaction with pre-existing risk factors in order to better manage neurological disease in the context of COVID-19. These results also inform the clinician that consideration of an alternative diagnosis and treatment for neurological presentations in this context is crucial, even in the patient with a confirmed diagnosis COVID-19. | ||
700 | 1 | |a Bremer, Marise |e verfasserin |4 aut | |
700 | 1 | |a Schäfer, Georgia |e verfasserin |4 aut | |
700 | 1 | |a Dixon, Luke |e verfasserin |4 aut | |
700 | 1 | |a Abrahams, Fatima |e verfasserin |4 aut | |
700 | 1 | |a Goliath, Rene T |e verfasserin |4 aut | |
700 | 1 | |a Maxebengula, Mpumi |e verfasserin |4 aut | |
700 | 1 | |a Proust, Alize |e verfasserin |4 aut | |
700 | 1 | |a Chavda, Anesh |e verfasserin |4 aut | |
700 | 1 | |a Black, John |e verfasserin |4 aut | |
700 | 1 | |a Wilkinson, Robert J |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t bioRxiv.org |g (2021) vom: 21. Mai |
773 | 1 | 8 | |g year:2021 |g day:21 |g month:05 |
856 | 4 | 0 | |u http://dx.doi.org/10.1101/2021.05.14.21254691 |z kostenfrei |3 Volltext |
912 | |a GBV_XBI | ||
912 | |a SSG-OLC-PHA | ||
951 | |a AR | ||
952 | |j 2021 |b 21 |c 05 | ||
953 | |2 045F |a 570 |