The diagnosis of Creutzfeldt–Jakob disease in a SARS-CoV-2-infected patient should be confirmed by brain biopsy or autopsy

Abstract

This letter to the Editor discusses the case of a 73-year-old male with mild SARS-CoV-2 infection who one month later developed rapidly progressive cognitive decline, and imaging findings suggestive of Creutzfeldt–Jakob disease (CJD). The diagnosis of sporadic CJD was made on the basis of clinical presentation (rapidly progressive decline, depression, gait disturbance, incontinence, mutism), cerebral MRI (small infarcts, atrophy), hybrid FDG-PET (putaminal and thalamic diffusion restriction, bifrontal hypometabolism), and elevated 14-3-3 in the cerebrospinal fluid (CSF). Despite administration of glucocorticoids, the patient died three months after the onset of symptoms. No autopsy was performed. This case raises the question of a possible link between SARS-CoV-2 infection and the subsequent development of CJD-like syndromes, which warrants further investigation.