PMC:7546130 / 9616-10715 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7546130","sourcedb":"PMC","sourceid":"7546130","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7546130","text":"The meaning of SARS-CoV-2 RNA positivity in the CSF of our patient is unclear. A direct effect of the virus, with normal proteins and no pleocytosis in the CSF, is questionable. Viral neurotropism has been largely theorized, and virus particles have been observed to cross the capillary endothelium of the brain blood barrier (BBB) [10], but direct implication of SARS-CoV-2 in neurological manifestations is controversial, and viral RNA in the CSF of patients with neurological complications is only rarely detected [11]. In a recent study including 31 patients with neurological manifestations, none had CSF viral positivity, but many had signs of disturbance of the blood brain barrier (BBB) integrity [12]. Our patient showed signs of mild damage of the BBB as well, which might also be a possible consequence of systemic inflammation, in a patient with multiple organ failure. Therefore, an indirect mechanism of neurovascular unit breakdown, resulting in a passage of the virus in the CSF through the damaged BBB, cannot be excluded. Contamination or artifact could also be a possibility 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