{"id":"f62b76e1-0a3e-4c15-9205-9a474e31c53b","slug":"reactivation-of-covid-19-in-a-neurosurgical-patient-with-early-neuropsychiatric-presentation-does-seroconversion-mean-immunity","title":"Reactivation of COVID-19 in a neurosurgical patient with early neuropsychiatric presentation. Does seroconversion mean immunity?","authors":["Giulio Bonomo","Dario Caldiroli","Roberta Bonomo","Raffaelino Pugliese","Francesco DiMeco","Cesare Zoia"],"abstract":"Background: In the aftermath of COVID-19 outbreak, there is a strong need to find strategies to monitor SARSCoV-2 transmission. While the application of screening techniques plays a major role to this end, there is evidence challenging the real significance of seroconversion. We reported a case of COVID-19 reactivation associated with a neurosurgical operation with early neuropsychiatric involvement presumably promoted by olfactory and gustatory impairment in the first infection. Case Descriptio: A 57-year-old man was referred for a 2-month history of progressive development of imbalance, dizziness, and vomiting. Magnetic resonance imaging showed two bilateral hemispheric cerebellar lesions. In line with our triage protocol, the patient underwent a nasopharyngeal swab for RNA of SARS-CoV-2 detection, which resulted positive. Of note, the patient had reported in the previous month hyposmia and hypogeusia. After a period of 14 days, three new swabs were performed with negative results, leading the way to surgery. In the early post-operative period, the patient manifested acute onset of psychotic symptoms with hyperactive delirium, followed by fever and acute respiratory failure. A chest computed tomography revealed a specific pattern of ground-glass opacities in the lower lobes bilaterally, suggesting a viral pneumonia. Serological tests demonstrated the seroconversion and a new nasopharyngeal swab confirmed SARS-CoV-2 infection. Conclusion: Our report highlights the importance of comprehensive screening assessments in sensitive cases highly susceptible to COVID-19 recurrence.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/f62b76e1-0a3e-4c15-9205-9a474e31c53b/featured/hero-1781562514225.png","publishDate":"2021-04-19T00:00:00.000Z","doi":"10.25259/SNI_831_2020","categories":["Infection","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2021/04/10741/SNI-12-166.pdf"}