• Shelli Farhadian, Laura R Glick, Chantal B F Vogels, Jared Thomas, Jennifer Chiarella, Arnau Casanovas-Massana, Jing Zhou, Camila Odio, Pavithra Vijayakumar, Bertie Geng, John Fournier, Santos Bermejo, Jos... more eph R Fauver, Tara Alpert, Anne L Wyllie, Cynthia Turcotte, Matthew Steinle, Patrick Paczkowski, Charles Dela Cruz, Craig Wilen, Albert I Ko, Sean MacKay, Nathan D Grubaugh, Serena Spudich, and Lydia Aoun Barakat. less
• Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, 06510, USA. shelli.farhadian@yale.edu.
• Bmc Neurol. 2020 Jun 18; 20 (1): 248.

BackgroundCOVID-19 is caused by the severe acute respiratory syndrome virus SARS-CoV-2. It is widely recognized as a respiratory pathogen, but neurologic complications can be the presenting manifestation in a subset of infected patients.Case PresentationWe describe a 78-year old immunocompromised woman who presented with altered mental status after witnessed seizure-like activity at home. She was found to have SARS-CoV-2 infection and associated neuroinflammation. In this case, we undertake the first detailed analysis of cerebrospinal fluid (CSF) cytokines during COVID-19 infection and find a unique pattern of inflammation in CSF, but no evidence of viral neuroinvasion.ConclusionOur findings suggest that neurologic symptoms such as encephalopathy and seizures may be the initial presentation of COVID-19. Central nervous system inflammation may associate with neurologic manifestations of disease.

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