TY - JOUR T1 - Status of SARS-CoV-2 in cerebrospinal fluid of patients with COVID-19 and stroke JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry DO - 10.1136/jnnp-2020-323522 SP - jnnp-2020-323522 AU - Fadi Al Saiegh AU - Ritam Ghosh AU - Adam Leibold AU - Michael B Avery AU - Richard F Schmidt AU - Thana Theofanis AU - Nikolaos Mouchtouris AU - Lucas Philipp AU - Stephen C Peiper AU - Zi-Xuan Wang AU - Fred Rincon AU - Stavropoula I Tjoumakaris AU - Pascal Jabbour AU - Robert H Rosenwasser AU - M. Reid Gooch Y1 - 2020/04/30 UR - http://jnnp.bmj.com/content/early/2020/04/30/jnnp-2020-323522.abstract N2 - Background Emergence of the novel corona virus (severe acute respiratory syndrome (SARS)-CoV-2) in December 2019 has led to the covid-19 pandemic. The extent of covid-19 involvement in the central nervous system is not well established, and the presence or the absence of SARS-CoV-2 particles in the cerebrospinal fluid (CSF) is a topic of debate.Case description We present two patients with covid-19 and concurrent neurological symptoms. Our first patient is a 31-year-old man who had flu-like symptoms due to covid-19 and later developed an acute-onset severe headache and loss of consciousness and was diagnosed with a Hunt and Hess grade 3 subarachnoid haemorrhage from a ruptured aneurysm. Our second patient is a 62-year-old woman who had an ischaemic stroke with massive haemorrhagic conversion requiring a decompressive hemicraniectomy. Both patients’ CSF was repeatedly negative on real-time PCR analysis despite concurrent neurological disease.Conclusion Our report shows that patients’ CSF may be devoid of viral particles even when they test positive for covid-19 on a nasal swab. Whether SARS-CoV-2 is present in CSF may depend on the systemic disease severity and the degree of the virus’ nervous tissue tropism and should be examined in future studies. ER -