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?:abstract
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OBJECTIVE: Assessment of the impact of cerebrospinal fluid (CSF) analysis including investigation for the presence of SARS-CoV-2 is essential for the optimization of patient care. METHODS: In this case series, we review patients diagnosed with SARS-CoV-2 undergoing LP admitted to Columbia University Irving Medical Center (New York, New York) from March 1-May 26, 2020. In a subset of patients, CSF SARS-CoV-2 quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) testing is performed. RESULTS: Average age of 27 patients who undergo LP with definitive SARS-CoV-2 is 37.5 years (SD 28.7). CSF profiles show elevated WBC counts and protein in 44% and 52% of patients, respectively. LP results impact treatment decisions in 10 (37%) patients, either by change of antibiotics, influence in disposition decision, or by providing an alternative diagnosis. CSF SARS-CoV-2 qRT-PCR is performed on 8 (30%) patients with negative results in all samples. CONCLUSIONS: Among patients diagnosed with SARS-CoV-2, CSF results change treatment decisions or disposition in over one-third of our patient cohort. CSF is frequently abnormal, though CSF SARS-CoV-2 qRT-PCR is negative in all samples. Further studies are required to define whether CSF SARS-CoV-2 testing is warranted in certain clinical contexts.
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