COVID-19 infection recurrence presenting with meningoencephalitis

M Mardani; S Alireza Nadji; K Aghazadeh Sarhangipor; A Sharifi-Razavi; M Baziboroun

doi:10.1016/j.nmni.2020.100732

COVID-19 infection recurrence presenting with meningoencephalitis

New Microbes New Infect. 2020 Jul 23:37:100732. doi: 10.1016/j.nmni.2020.100732. eCollection 2020 Sep.

Authors

M Mardani¹, S Alireza Nadji², K Aghazadeh Sarhangipor³, A Sharifi-Razavi⁴, M Baziboroun¹

Affiliations

¹ Infectious Disease and Tropical Medicine Research Center, Iran.
² Virology Research Center, National Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Science, Iran.
³ Infectious Disease Research Center, AJA University of Medical Science, Tehran, Iran.
⁴ Clinical Research Development Unit of Bou-Ali Sina Hospital, Mazandarn University of Medical Science, Sari, Iran.

Abstract

Coronavirus disease 2019 (COVID-19) infection can involve many organs, such as central nervous system, including in relapse. We describe the case of a 64-year-old woman with microbiologically confirmed COVID-19-induced respiratory distress whose treatment resulted in a negative nasopharyngeal swab reverse transcriptase PCR (RT-PCR) result for COVID-19. However, after a few weeks, relapse occurred, as indicated by symptoms of acute meningoencephalitis. Results of COVID-19 RT-PCR testing from her cerebrospinal fluid, nasopharyngeal and tracheal aspiration specimens became positive again, but COVID-19 serum antibodies were negative. We therefore note that symptoms with neurologic involvement can be one of COVID-19's first presentations, or they can appear at relapse. Regular evaluation of patients during convalescence is therefore necessary.

Keywords: COVID-19; Encephalitis; Meningitis; Nervous system; Recurrence.