SARS-CoV-2 RNA in the Cerebrospinal Fluid of a Patient with Long COVID

Abstract

Over 10% of COVID-19 convalescents report post-COVID-19 complications, namely, ‘long COVID’ or ‘post-COVID syndrome,’ including a number of neuro-psychiatric symptoms. The pathophysiology of COVID-19 in the central nervous system is poorly understood but may represent post-COVID injury, ongoing sterile maladaptive inflammation, or SARS-CoV-2 persistence. We describe a long COVID patient with SARS-CoV-2 RNA in the cerebrospinal fluid, which seems important, specifically due to recent reports of gray matter volume loss in COVID-19 patients. Further studies of SARS-CoV2 RNA, markers of inflammation, and neuronal damage in the CSF of patients with long COVID would be useful and should address whether the CNS can serve as a reservoir of SARS-CoV-2, clarify the pathway by which COVID-19 contributes to CNS dysfunction, and how best to therapeutically address it.

SARS-CoV-2-specific T cells associate with inflammation and reduced lung function in pulmonary post-acute sequalae of SARS-CoV-2

“…The presence of persistent viral reservoirs of SARS-CoV-2 has been proposed as a possible explanation of PASC pathophysiology [ 26 ]. Studies in macaques and humans demonstrated viral replication can persist months after initial infection in multiple organ systems [ 27 – 30 ] and viral presence in cerebrospinal fluid has been observed in neurological PASC [ 31 ]. Alternatively, damage resulting from severe disease during acute infection has also been proposed as a cause of PASC [ 26 ].…”

SARS-CoV-2-specific T cells associate with reduced lung function and inflammation in pulmonary post-acute sequalae of SARS-CoV-2

“…The presence of persistent viral reservoirs of SARS-CoV-2 has been proposed as a possible explanation of PASC pathophysiology (27). Studies in macaques and humans demonstrated viral replication can persist months after initial infection in multiple organ systems (28)(29)(30)(31) and viral presence in cerebrospinal fluid has been observed in neurological PASC (32). Alternatively, damage resulting from severe disease during acute infection has also been proposed as a cause of PASC (27).…”

Cerebral microvascular complications associated with SARS-CoV-2 infection: How did it occur and how should it be treated?

“…Multiple neurological symptoms such as loss of smell (anosmia), loss of coordination of movement (ataxia), headache, dizziness, increased vascular inflammation, encephalitis, and stroke have been observed following infection with SARS-CoV-2, which may indicate viral tropism for brain cells [52] . Recently, it has been reported that the SARS-CoV-2 genome was detected in the cerebrospinal fluid (CSF) and several reports suggest that respiratory viruses like SARS-Cov-2 may reach the CNS through various routes [53] , [54] . The olfactory pathway is one of the strongest candidate routes that contains several nerves [55] , [56] .…”