Cerebrospinal fluid cytochemical analysis from COVID-19 patients with neurological disorders

Abstract

Background: The COVID-19 pandemic caused by SARS-CoV-2 has affected millions of people around the world. Most cytochemical studies of cerebrospinal fluid (CSF) in patients infected with SARS-CoV-2 have shown abnormal results. The objective of the present investigation was to determine the physical, cytological, and chemical alterations of the CSF cytochemical examination of COVID-19 patients with neurological disorders in Peru. Methods: An observational and cross-sectional study was carried out at the Edgardo Rebagliati Martins Hospital. The study population consisted of 94 CSF samples obtained by lumbar puncture from inpatient patients. Likewise, the paired T-test and one-way ANOVA with the Bonferroni post-hoc test was used to determine the differences in the values of CSF biochemical markers. Results: The most frequent neurological disorders were encephalopathy (43%) and brain tumor (23%). The most relevant physical characteristics were cloudy and reddish fluids in the brain tumor and intracerebral hemorrhage; however, in encephalopathies, transparent-looking liquids were observed. CSF glucose from patients with encephalopathy (30%) and intracerebral hemorrhage (13%) had concentrations >70 mg/dL. Proteins >45mg/dl corresponded to 20% of patients with encephalopathy and 17% of patients with intracerebral hemorrhage and brain tumor. Likewise, no differences were found in glucose concentration between neurological disorders (p>0.05); however, differences in protein concentration were observed (p=0.001). Finally, among the cytological characteristics, it was found that patients with encephalopathy (33%) and brain tumor (20%) presented a leukocyte count <5 cells/ul. Conclusion: These findings suggest that the characteristics of CSF may differ depending on the type of neurological complication experienced by patients with COVID-19.