Incidence of Coronavirus-2 in cerebrospinal fluid in pregnant Coronavirus Disease 2019 (COVID-19) patients with neurological symptoms

Abstract

Background: The aim of this prospective cohort study was to investigate the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the cerebrospinal fluid (CSF) of pregnant women with neurological symptoms due to coronavirus disease 2019 (COVID-19). Materials and Methods: This research was carried out in the Samsun University. Department of Anesthesiology and Reanimation from December 2021 to May 2022. Pregnant women exhibiting neurological symptoms linked to COVID-19 were assigned to one of the two groups, depending on the severity of the disease–mild (Group 1) and severe (Group 2). Specimens were collected from patients’ CSF, and the presence of SARS-CoV-2 was investigated using the reverse transcription-polymerase chain reaction (RT-PCR) method. SARS-CoV-2 was also investigated using RT-PCR by collecting oropharyngeal swab specimens from infants in the first 6 h after birth. Results: One hundred fifty patients were enrolled, 75 in both groups. The most frequent neurological symptoms were dizziness in Group 1 (52%) and headache in Group 2 (32%). No significant differences were determined in neutrophils, lymphocytes, hemoglobin, leukocytes, platelets, ferritin, D-dimer, C-reactive protein, prothrombin time, aspartate aminotransferase, alanine aminotransferase, creatinine, sedimentation, or fibrinogen values. SARS-CoV-2 was identified in the CSF of only one patient, from Group 2. Infant oropharyngeal swab specimens tested negative for SARS-CoV-2 using RT-PCR. Conclusion: This study indicates that the detection of SARS-CoV-2 in CSF via RT-PCR is rare. We suggest that neurological symptoms linked to SARS-CoV-2 are not caused by direct invasion and that other etiologies represent more likely mechanisms.

Keywords

• cerebrospinal fluid
• covid-19
• nervous system
• pregnancy
• sars-cov-2