Incidence of Coronavirus-2 in cerebrospinal fluid in pregnant Coronavirus Disease 2019 (COVID-19) patients with neurological symptoms

Background: The aim of this prospective cohort study was to investigate the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the cerebrospinal fluid (CSF) of pregnant women with neurological symptoms due to coronavirus disease 2019 (COVID-19). Materials and Methods: This research was carried out in the Samsun University. Department of Anesthesiology and Reanimation from December 2021 to May 2022. Pregnant women exhibiting neurological symptoms linked to COVID-19 were assigned to one of the two groups, depending on the severity of the disease-mild (Group 1) and severe (Group 2). Specimens were collected from patients' CSF, and the presence of SARS-CoV-2 was investigated using the reverse transcription-polymerase chain reaction (RT-PCR) method. SARS-CoV-2 was also investigated using RT-PCR by collecting oropharyngeal swab specimens from infants in the first 6 h after birth. Results: One hundred fifty patients were enrolled, 75 in both groups. The most frequent neurological symptoms were dizziness in Group 1 (52%) and headache in Group 2 (32%). No significant differences were determined in neutrophils, lymphocytes, hemoglobin, leukocytes, platelets, ferritin, D-dimer, C-reactive protein, prothrombin time, aspartate aminotransferase, alanine aminotransferase, creatinine, sedimentation, or fibrinogen values. SARS-CoV-2 was identified in the CSF of only one patient, from Group 2. Infant oropharyngeal swab specimens tested negative for SARS-CoV-2 using RT-PCR. Conclusion: This study indicates that the detection of SARS-CoV-2 in CSF via RT-PCR is rare. We suggest that neurological symptoms linked to SARS-CoV-2 are not caused by direct invasion and that other etiologies represent more likely mechanisms.