Detection of SARS-coronavirus-2 in the central nervous system of patients with severe acute respiratory syndrome and seizures

Abstract

This study was designed to evaluate whether severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can directly target the central nervous system (CNS). We present four patients suffering from the loss of consciousness and seizure during the clinical course of COVID-19 infection. In addition to positive nasopharyngeal swab tests, SARS-CoV-2 has been detected in their cerebrospinal fluid. This report indicates the neuroinvasive potential of SARS-CoV-2, suggesting the ability of this virus to spread from the respiratory tract to the CNS.

Keywords: Brain; CNS; Convulsion; Neuroinvasion; SARS-CoV-2.

Fig. 1

Lung CT scan, Neuroimaging, and RT-PCR findings in different patients. A Ground-glass consolidation is seen in the lung HRCT of all patients. B Brain MRI, brain CT scan, and RT-PCR of patients. B-a Bilateral asymmetrical areas of the hyper-signal intensity of the temporal lobes, the inferior area of the frontal lobes, the insula, and the right parietal lobe in T2 and FLAIR images, with patchy restricted areas, were seen in patient 1. B-b RT-PCR amplification plot on the CSF sample of the patient 1 (reactions include sample, negative control, positive control, and negative control of extraction). B-b' RT-PCR amplification plot on the nasopharyngeal (NP) swab specimen of patient 1. B-c Small size hyper-intense foci in the subcortical white matter of the parietal and temporal lobes in T2 and FLAIR images of brain MRI (yellow arrow). B-d RT-PCR amplification plot on the CSF sample of patient 2 (reactions include sample, negative control, positive control, and negative control of extraction). B-d' RT-PCR amplification plot on the NP swab samples of the patient 2. B-e Brain CT scan of patient 3 did not show remarkable changes. B-f RT-PCR amplification plot of the CSF sample of patient 3 (reactions include sample, negative control, positive control, and negative control of extraction). B-f' RT-PCR amplification plot on the NP swab specimens of the patient 3. B-g A brain CT scan revealed senile atrophies and chronic small vessel changes.B-h RT-PCR amplification plot of the CSF sample of patient 4 (reactions include sample, negative control, positive control, and negative control of extraction). B-h' RT-PCR amplification plot on the NP swab sample of the patient 4