Neurologic Manifestations of COVID-19


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Kenneth D. -

THANK YOU, SWAMI! At my institution they are COVID crazy and forget a lot of the other things that cause febrile illnesses, N/V, chest pain, etc.

Carlos G. -

Do you order the chest CT part with IV contrast?
Are you aware of any data of procalcitonin level in the setting of bacterial meningitis?

Anand S. -

Chest CT can be non-contrast here since you're really looking at the lung fields not the vasculature. Theoretically, you could look for PE w/ a CTA but I think you'd have timing issues with the CTA of the head.
In general, procal is a test looking for a disease. I don't think you can use it to reliably rule out bacterial meningitis. There are articles out there supporting it's use but most are small and have significant methodological issues.

Evie M. -

Hi Carlos, Chest CT without contrast will give you an idea if the patient has the pulmonary picture consistent with covid that many have seen in asymptomatic patients.
Procalcitonin has been studied a lot over the years with regard to bacterial meningitis - here are a couple of PMIDs that you might find interesting.
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