Rapid progression of probable Creutzfeldt-Jakob disease with concomitant COVID-19 infection

Abstract

A previously healthy man in his 80s was admitted to a district general hospital with rapidly progressing dementia, gait abnormalities and myoclonus alongside COVID-19 infection. Investigations showed mild elevation of C-reactive protein and neutrophils, unremarkable CT head and mildly raised protein in cerebrospinal spinal fluid (CSF). Brain MRI revealed bilateral cortical and striatal diffusion restriction and electroencephalogram (EEG) findings showed diffuse activity slowing with high amplitude sharp/slow-wave complexes. He was diagnosed with probable sporadic Creutzfeldt-Jakob disease (CJD) and management prioritised comfort and care. He passed away two weeks following admission and a mere 8 weeks after the first onset of symptoms.We present the first documented case of probable CJD with concomitant COVID-19 infection in the UK. We identified six other cases worldwide identified in our literature review. These cases suggest a role of COVID-19 in the rapid progression of CJD and add to the growing evidence of its neuroinflammatory role in other forms of neurodegenerative diseases.

Creutzfeldt–Jakob Disease Associated with E200K Mutation and SARS-CoV-2 Infection: Pure Coincidence or Neurodegenerative Acceleration?

“…Durin one of the worst global pandemics of the last century, caused by the COVID-19 disease under the persistent immune pressure exerted by the newest vaccines, the SARS-CoV virus is fast mutating and becoming less severe but more contagious. On the other hand some studies [7][8][9] indicate that elderly COVID-19 patients, or those who have reported virulent episode of this infection, experience some long-lasting neurological complica tions, including encephalopathy, encephalitis, cerebrovascular disease, Parkinson' disease (PD), Alzheimer's disease (AD), and prion disease (PrD). Before the COVID-1 outbreak, the principal cause of rapidly progressive dementia was certainly prion disease excluding infectious, metabolic, vascular, neoplastic, and autoimmune disorders Nowadays, a growing number of studies demonstrated that patients surviving COVID 19 can show the neuroinflammatory activation of microglia and astrocytes that migh favor the fast development of neurodegenerative diseases, such as CJD [9].…”