{
  "abstract": "Background\n\nAlthough SARS-CoV-2 infection is primarily associated with respiratory symptoms, neurological complications have been increasingly recognized, even in the absence of pulmonary involvement.Case presentation\n\nWe report a case of a 67-year-old woman with a history of multiple myeloma and recent exposure to a COVID-19-positive individual who developed rapidly progressive neurological symptoms, including dysarthria, dysphagia, and hypoesthesia, without any respiratory manifestations. Her condition deteriorated to focal and dyscognitive status epilepticus, requiring mechanical ventilation. Brain MRI showed imaging features consistent with rhombencephalitis. SARS-CoV-2 infection was confirmed through positive qRT-PCR results from both nasopharyngeal swab and cerebrospinal fluid (CSF). Further analysis of the CSF using quantitative shotgun proteomics via mass spectrometry revealed a neuroinflammatory profile indicative of blood-brain barrier disruption and differential expression of several proteins relevant to brain function, including the major prion protein, superoxide dismutase 1 (SOD-1), and other aggregation-prone proteins.Conclusions\n\nThis case supports the hypothesis that SARS-CoV-2 can invade the central nervous system and cause severe neurological impairment, even in the absence of typical respiratory symptoms. The findings underscore the importance of considering SARS-CoV-2 in the differential diagnosis of rapidly progressive neurological syndromes and highlight the need for further investigation into the mechanisms of neuroinvasion and the potential neurotropism of emerging viral variants.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Hematology and Cell Therapy, A.C.Camargo Cancer Center, São Paulo, SP, Brazil.",
    "Reference Center for Hematologic Neoplasms at the A.C.Camargo Cancer Center, São Paulo, Brazil.",
    "Department of Neurology, A.C.Camargo Cancer Center, São Paulo, Brazil.",
    "Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil.",
    "Intensive Care Unit, A.C.Camargo Cancer Center, São Paulo, Brazil.",
    "Department of Infectious Diseases and Infection Control, A.C.Camargo Cancer Center, R. Prof. Antônio Prudente, 211 - Liberdade, São Paulo, SP, 01509-010, Brazil.",
    "Laboratory of Computational Biology, A.C.Camargo Cancer Center, São Paulo, Brazil.",
    "Experimental Medicine Research Cluster (EMRC), University of Campinas (UNICAMP), Campinas, SP, Brazil.",
    "Autoimmune Research Laboratory, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil.",
    "Laboratory of Virology, Grupo Fleury, São Paulo, Brazil.",
    "Department of Imaging, A.C.Camargo Cancer Center, São Paulo, Brazil.",
    "Laboratory of Medical Genomics, A.C.Camargo Cancer Center, São Paulo, Brazil.",
    "Rutgers Cancer Institute, Newark, USA.",
    "Division of Cancer Biology, Department of Radiation Oncology, Rutgers New Jersey Medical School, Newark, USA.",
    "Translational Immuno-oncology Group, International Research Center, A.C. Camargo Cancer Center, São Paulo, Brazil.",
    "D'Or Institute for Research and Education (IDOR), São Paulo, Brazil.",
    "Translational Immuno-oncology Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil.",
    "Center for Research in Immuno-oncology (CRIO), Hospital Israelita Albert Einstein, São Paulo, Brazil.",
    "INCT in Modelling Human Complex Diseases With 3D Platforms (Model3D), São Paulo, Brazil.",
    "Department of Cell Biology and Development, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.",
    "National Institute of Science and Technology in Oncogenomic and Pharmaceutical Innovation, São Paulo, Brazil.",
    "Reference Center for Hematologic Neoplasms at the A.C.Camargo Cancer Center, São Paulo, Brazil. marjorie.batista@accamargo.org.br.",
    "Intensive Care Unit, A.C.Camargo Cancer Center, São Paulo, Brazil. marjorie.batista@accamargo.org.br.",
    "Department of Infectious Diseases and Infection Control, A.C.Camargo Cancer Center, R. Prof. Antônio Prudente, 211 - Liberdade, São Paulo, SP, 01509-010, Brazil. marjorie.batista@accamargo.org.br."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 21,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Jayr Schmidt-Filho"
    },
    {
      "affs": [
        2
      ],
      "name": "Thais Rodrigues B Geraldo"
    },
    {
      "affs": [
        3
      ],
      "name": "Victor C Carregari"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Marina de Mattos Nascimento"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Anita Cassoli Cortez"
    },
    {
      "affs": [
        4
      ],
      "name": "Ramon Teixeira Costa"
    },
    {
      "affs": [
        5
      ],
      "name": "Ivan Leonardo Avelino Franca-Silva"
    },
    {
      "affs": [
        6
      ],
      "name": "Israel Tojal da Silva"
    },
    {
      "affs": [
        2
      ],
      "name": "Marcos Aurélio Peterlevitz"
    },
    {
      "affs": [
        7,
        8
      ],
      "name": "Alessandro S Farias"
    },
    {
      "affs": [
        2
      ],
      "name": "José Eduardo Vitorino Galon"
    },
    {
      "affs": [
        9
      ],
      "name": "Ana Maria Fraga"
    },
    {
      "affs": [
        9
      ],
      "name": "Celso Francisco Hernandes Granato"
    },
    {
      "affs": [
        10
      ],
      "name": "Gislaine Cristina Lopes Machado Porto"
    },
    {
      "affs": [
        11,
        12,
        13
      ],
      "name": "Diana Noronha Nunes"
    },
    {
      "affs": [
        14
      ],
      "name": "Dirce Maria Carraro"
    },
    {
      "affs": [
        15,
        16,
        17
      ],
      "name": "Kenneth J Gollob"
    },
    {
      "affs": [
        11,
        12,
        13
      ],
      "name": "Emmanuel Dias-Neto"
    },
    {
      "affs": [
        3,
        7,
        15,
        18,
        19,
        20
      ],
      "name": "Daniel Martins-de-Souza"
    },
    {
      "affs": [
        18,
        19,
        20
      ],
      "name": "Vilma R Martins"
    },
    {
      "affs": [
        21,
        22,
        23
      ],
      "name": "Marjorie Vieira Batista",
      "orcid": "0000-0002-2141-6879"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8w9de4574gcm4.bib",
  "cited_by": 0,
  "doi": "10.1007/s10072-026-09471-w",
  "fulltext_url": "https://europepmc.org/articles/PMC13677627",
  "id": "8w9de4574gcm4",
  "issns": [
    "1590-1874",
    "1590-3478"
  ],
  "landing_url": "https://europepmc.org/article/MED/42894086",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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      "openalex",
      "2728|Long-Term Effects of COVID-19"
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  "openalex": "W7222871100",
  "pdf_url": "https://europepmc.org/articles/PMC13677627?pdf=render",
  "pmcid": "PMC13677627",
  "pmid": "42894086",
  "published": "2026-10-19",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/8w9de4574gcm4.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:32Z",
      "native_id": "MED:42894086",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42894086"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2728|Long-Term Effects of COVID-19",
      "subfield": "neurology"
    }
  ],
  "title": "Cerebrospinal fluid positive for SARS-CoV-2 associated with neurological manifestations and proteome alterations in a multiple myeloma patient.",
  "title_text": "Cerebrospinal fluid positive for SARS-CoV-2 associated with neurological manifestations and proteome alterations in a multiple myeloma patient.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:32Z",
  "url": "https://research.draconitic.com/paper/8w9de4574gcm4",
  "venue": "Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology",
  "versions": []
}