Acute Cerebellitis and Myeloradiculitis Associated With SARS-CoV-2 Infection in Common Variable Immunodeficiency—A Case Report

Author:

Lemus Hernan Nicolas1ORCID,Alkayyali Miryam1,Kim Eonjung1,Cunnigham-Rundles Charlotte2,Pyburn Dewitt1,Abrams Rory3

Affiliation:

1. Department of Neurology, Icahn School of Medicine at Mount Sinai Downtown, New York, NY, USA

2. Department of Immunology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA

3. Department of Neurology, Icahn School of Medicine at Mount Sinai West, New York, NY, USA

Abstract

The role of the adaptive immune system in mediating COVID-19 is largely unknown. Therefore, it is difficult to predict the clinical course in patients with common variable immunodeficiency (CVID), a disease characterized by dysfunctional lymphocytes and impaired antibody production. We report a case of SARS-CoV-2 infection presenting as isolated neurological symptoms in a patient with CVID. The patient subsequently improved following steroids, intravenous immunoglobulin, and convalescent plasma (CP). The latter has been shown to be safe and efficacious in treating COVID-19 in patients with primary immunodeficiency. Recent data suggest that the mechanism of CNS injury in COVID-19 may be due to immunological dysregulation rather than direct viral-mediated injury. This case exemplifies the complex interaction between the brain, the immune system, and the SARS-CoV-2 virus.

Publisher

SAGE Publications

Subject

Neurology (clinical)

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