Early Release-Encephalopathy and Encephalitis Associated with Cerebrospinal Fluid Cytokine Alterations and Coronavirus Disease, Atlanta, Georgia, USA …

Few detailed investigations of neurologic complications in severe acute respiratory syndrome coronavirus 2 infection have been conducted. We describe 3 patients with laboratory-confirmed coronavirus disease who showed development of encephalopathy and encephalitis. Neuroimaging showed nonenhancing unilateral, bilateral, and midline changes not readily attributable to vascular causes. All 3 patients had increased cerebrospinal fluid (CSF) levels of anti-S1 IgM. One patient who died also had increased levels of anti?envelope protein IgM. CSF analysis also showed markedly increased levels of interleukin (IL) 6, IL-8, and IL-10, but severe acute respiratory syndrome coronavirus 2 was not identified in any CSF sample. These changes provide evidence of CSF periinfectious/postinfectious inflammatory changes during coronavirus disease with neurologic complications.