There are few detailed investigations of neurologic complications in severe acute respiratory syndrome coronavirus 2 infection. We describe 3 patients with laboratory-confirmed coronavirus disease who had encephalopathy and encephalitis develop. 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.
Keywords: Atlanta; COVID-19; CSF; Georgia; SARS-CoV-2; United States; cerebrospinal fluid; coronavirus disease; coronaviruses; cytokines; encephalitis; encephalopathy; meningitis/encephalitis; respiratory infections; serologic analysis; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.