Three-tier stratification for CNS COVID-19 to help decide which patients should undergo lumbar puncture with CSF analysis: a case report and literature review

Jahanavi M. Ramakrishna, Claudia R. Libertin, Jason Siegel, Matthew J. Binnicker, Dana Harris, Gautam V. Matcha, Thomas Caulfield, W. D. Freeman

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

The COVID-19 pandemic continues to overwhelm global healthcare systems. While the disease primarily causes pulmonary complications, reports of central nervous system (CNS) involvement have recently emerged ranging from encephalopathy to stroke. This raises a practical dilemma for clinicians as to when to pursue neuroimaging and lumbar tap with cerebrospinal fluid (CSF) analysis in COVID-19 patients with neurological symptoms. We present a case of an encephalopathic patient infected with SARS-CoV-2 with no pulmonary symptoms. We propose a three-tier risk stratification for CNS COVID-19 aiming to help clinicians to decide which patients should undergo CSF analysis. The neurological examination remains an integral component of screening and evaluating patients for COVID-19 considering the range of emerging CNS complications.

Original languageEnglish (US)
Pages (from-to)88-92
Number of pages5
JournalRomanian Journal of Internal Medicine
Volume59
Issue number1
DOIs
StatePublished - Mar 1 2021

Keywords

  • cerebral spinal fluid
  • COVID-19
  • encephalitis
  • lumbar puncture
  • SARS-CoV-2

ASJC Scopus subject areas

  • Medicine(all)

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