Table 3.
CSF findings in 24 COVID-19 patients with neurological manifestations.
| Total n = 24a |
Encephalopathy n = 17a |
Meningoencephalitis n = 7a |
P | |
|---|---|---|---|---|
| Time between first neurological symptoms and LP (in days) (n = 23) | 5 [3–12] | 5 [3–13] | 4 [2–4] | 0.121 |
| WCC (cell/μL) | 2 [0–5] | 1 [0–2] | 8 [6–28] | < 0.001 |
| Abnormal WCC (> 4/μL) | 7 (29%) | 0 (0%) | 7 (100%) | < 0.001 |
| Protein (g/L) | 0.42 [0.29–0.60] | 0.34 [0.22–0.44] | 0.62 [0.52–0.97] | 0.003 |
| Abnormal protein (> 0.4 g/L) | 12 (50%) | 5 (29%) | 7 (100%) | 0.005 |
| Isoelectric focusing of CSFb (n = 23) | 0.199 | |||
| Type 1 pattern | 10 (43%) | 6 (35%) | 4 (67%) | |
| Type 2 pattern | 2 (8.7%) | 1 (5.9%) | 1 (17%) | |
| Type 3 pattern | 11 (48%) | 10 (59%) | 1 (17%) | |
| IgG index (n = 23) | 0.62 [0.47–0.71] | 0.62 [0.49–0.65] | 0.60 [0.42–0.74] | 0.972 |
| Abnormal IgG index (> 0.7) | 6 (26%) | 3 (18%) | 3 (50%) | 0.279 |
| Albumin ratio (CSF/serum) (n = 23) | 0.006 [0.004–0.010] | 0.005 [0.004–0.007] | 0.012 [0.008–0.015] | 0.020 |
| Abnormal albumin ratio (≥ 0.0075) | 7 (30%) | 3 (18%) | 4 (67%) | 0.045 |
| Neopterin (nmol/l) (n = 24) | 9.1 [5.6–22.1] | 9.1 [6.6–22.9] | 6.4 [5.3–20.4] | 0.525 |
| Abnormal neopterin (> 5 nmol/L) | 18 (75%) | 13 (76%) | 5 (71%) | 1.000 |
| Positive anti-SARS-CoV-2 IgM (n = 15) | 2 (13%) | 0 (0%) | 2 (50%) | 0.057 |
| Positive anti-SARS-CoV-2 IgG (n = 17) | 6 (35%) | 4 (33%) | 2 (40%) | 1.000 |
| NfL (ng/L) (n = 19) | 2905 [1428–7124] | 3177 [2017–5846] | 1428 [918–7766] | 0.368 |
| Total-tau (ng/L) (n = 21) | 256 [199–394] | 265 [206–417] | 199 [170–294] | 0.407 |
| Abnormal T-tau (> 400) | 5 (24%) | 4 (25%) | 1 (20%) | 1.000 |
| Phosphorylated-tau 181 (ng/L) (n = 21) | 32 [20–37] | 33 [21–43] | 22 [20–32] | 0.363 |
| Abnormal P-tau (> 60) | 1 (4.8%) | 1 (6.2%) | 0 (0%) | 1.000 |
| Aß1-42 peptide (ng/L) (n = 21) | 536 [432–904] | 516 [423–838] | 808 [475–904] | 0.660 |
| Abnormal Aß1-42 (< 550) | 11 (52%) | 9 (56%) | 2 (40%) | 0.635 |
| Aß1-42/Aß1-40 ratio (n = 21) | 0.082 [0.060–0.096] | 0.082 [0.059–0.091] | 0.097 [0.073–0.101] | 0.130 |
| Abnormal Aß1-42/Aß1-40 (< 0.055) | 0 (0%) | 0 (0%) | 0 (0%) | |
| 14-3-3 protein (n = 23) | 0.526 | |||
| Intermediate | 2 (8.7%) | 1 (6.2%) | 1 (14%) | |
| Negative | 21 (91%) | 15 (94%) | 6 (86%) |
CSF: cerebrospinal fluid; IgG: immunoglobulin G; IgM: immunoglobulin M; NfL: neurofilament light chain; P-tau: phosphorylated-tau; T-tau: total-tau; WCC: white cell count. In bold, corresponds to significant results (p < 0.05).
Median [IQR]; n (%).
Type 1: no specific band in CSF and serum (normal); type 2: specific oligoclonal IgG bands in the CSF and no corresponding band in serum (intrathecal IgG synthesis); type 3: IgG oligoclonal bands in CSF and additional identical bands in the CSF and serum (intrathecal IgG synthesis); type 4: similar oligoclonal bands in the CSF and serum (systemic, no intrathecal IgG synthesis); type 5: monoclonal bands in CSF and serum (no IgG synthesis in CNS).