Cerebrospinal fluid (CSF) inflammation according to neopterin and β2 microglobulin (β2M) biomarkers was present in all patients, but there was no corresponding CSF pleocytosis, blood-brain-barrier (BBB) disruption or intrathecal immunoglobulin G (IgG) production. SARS-CoV-2 RNA was only found in the plasma of 2 patients, and CSF detection was unclear; thus, direct neuroinvasion by SARS-CoV-2 may not be the underlying mechanism behind central nervous system (CNS) immunoactivation.
Why this matters
While neurological manifestations are common in coronavirus-19 (COVID-19), their underlying mechanisms are unclear. Understanding mechanisms contributing to COVID-19 neurological symptoms may aid in improved treatment outcomes.