Systematic SARS-CoV-2 screening in cerebrospinal fluid during the COVID-19 pandemic

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has emerged since December, 2019, and spread worldwide, causing the COVID-19 pandemic. Despite COVID-19 being a respiratory tract infection, the pathophysiology in both adults and children is incompletely understood. Neurological signs and symptoms—from headache to meningitis—have been reported in hospitalised patients.1,2 SARS-CoV-2 can enter and replicate in neuronal cells in vitro,3 but the association between neurological manifestations and presence of SARS-CoV-2 in cerebrospinal fluid (CSF) has only been tested in a few cases, with one patient testing positive for SARS-CoV-2 in a case report4 and seven of seven patients testing negative in a case series.