Background Neurological manifestations of coronavirus disease 2019 (COVID-19) are increasingly recognized and include encephalopathy, although direct infection of the brain by SARS-CoV-2 remains controversial. We herein report the clinical course and cytokine profiles of a patient with severe SARS-CoV-2-related encephalopathy presenting aphasia. Case presentation An 81-year-old man developed acute consciousness disturbance and status epileptics several days after SARS-CoV-2 infection. Following treatment with remdesivir and dexamethasone, his consciousness and epileptic seizures improved; however, amnestic aphasia and agraphia remained. Two months after methylprednisolone pulse and intravenous immunoglobulin, his neurological deficits improved. We found increased levels of interleukin (IL)-6, IL-8, and monocyte chemoattractant protein-1 (MCP-1), but not IL-2 and IL-10 in the serum and cerebrospinal fluid (CSF), and the levels of serum IL-6 and MCP-1 were much higher than those in the CSF. The level of IL-8 in the CSF after immunotherapy was four times higher than that before immunotherapy. Conclusion The cytokine profile of our patient was similar to that seen in severe SARS-CoV-2-related encephalopathy. We demonstrated (i) that the characteristic aphasia can occur as a focal neurological deficit associated with SARS-CoV-2-related encephalopathy, and (ii) that IL8-mediated central nervous system inflammation follows systemic inflammation in SARS-CoV-2-related encephalopathy and can persist and worsen even after immunotherapy. Monitoring IL-8 in CSF, and long-term corticosteroids may be required for treating SARS-CoV-2-related encephalopathy. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02459-3.
【저자키워드】 SARS-CoV-2, Case report, IL-8, Encephalopathy, Aphasia, 【초록키워드】 Corticosteroid, COVID-19, Dexamethasone, Methylprednisolone, Treatment, coronavirus disease, Inflammation, Intravenous immunoglobulin, IL-6, Immunotherapy, SARS-COV-2 infection, Remdesivir, Brain, serum, Clinical course, Patient, MCP-1, monitoring, Central nervous system, systemic inflammation, cerebrospinal fluid, IL-10, characteristic, cytokine profile, IL-2, CSF, Seizure, manifestation, monocyte chemoattractant protein-1, supplementary material, pulse, direct infection, Neurological deficit, include, remained, required, occur, demonstrated, much higher, presenting, increasingly, 【제목키워드】 Patient, persistent, presenting,