Case report of brain injury in multisystem inflammatory syndrome caused by SARS-CoV-2

Abstract

Background: COVID-19 pandemic has been ravaging since December 2019, however comprehensive standards for therapy have emerged relatively recently. Furthermore, considering multisystem disorders and various clinical manifestations of SARS-CoV-2, a personal approach to each patient is required. We searched databases including PubMed, Scopus, Google Scholar, Medline, and Elibrary and found no case study on meningitis caused by SARS-CoV-2 in children, so our analysis might be accepted as a unique clinical case of acute hydro meningitis associated with multisystem inflammatory syndrome (MIS) in a 10-year-old child with a severe form of SARS-CoV-2. Since SARS-CoV-2 is reported to mediate neurological pathology and acute brain injury, this case report suggests a potential treatment option. Therefore, we would like to present our analysis of a new case of SARS-CoV-2 patient, who was characterized by acute damage to central nervous system (CNS) and severe meningitis. During hospitalization the patient showed severe meningitis coincident with 75% acute lung damage. The patient presented with neutrophilia, an increase of plasma C-reactive protein (CRP), interleukin-6 (IL-6), elevated levels of enzymes (LDH, AST and ALT) and moderate signs of DICS (D-dimer, thrombocytopenia). The patient was found SARS-CoV-2 positive by RT-PCR analysis of patient's cerebrospinal fluid (CSF) sample. Patient was comprehensively treated by combination of antiviral, antibacterial and supportive therapy, and finally discharged 22 days after admissions. Conclusion: SARS-CoV-2 infection in children may result in severe damage to the CNS and the development of meningitis. This observation is in line with all-cause dementia (ACD) occurrences in adults and suggests a conduction of an early RT-PCR COVID-19 test for CSF for patients with meningitis symptoms.