Abstract

Background: CNS symptoms have been reported in individuals affected by Coronavirus disease 19 (COVID-19). Gut microbiota can affect central physiology via the microbiota-gut-brain axis. We describe Tourette’s-like symptoms resulting from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection disrupting gut microbiota.

Materials and Methods: A 16-year-old female developed acute-onset Tourette’s-like and neuropsychiatric symptoms after exposure to and infection from SARS-CoV-2. The patient had negative Nasopharyngeal (NP) real-time Reverse Transcription-PCR (RT-PCR) tests for SARS-CoV-2 on five occasions from August of 2020 through June of 2021. The patient’s symptoms worsened over the next six months until Next-Generation Sequencing (NGS) revealed SARS-CoV-2 in her stool. Repair of the gastrointestinal microbiota, treatment with nutraceuticals and pharmaceuticals and changing her surroundings drastically improved her microbiome and sizably reduced symptoms.

Conclusion: The use of nasopharyngeal RT-PCR testing for SARS-CoV-2 may be inadequate and inaccurate for individuals exposed to the virus. The impact of SARS-CoV-2 infection to the GI tract may cause significant havoc in the gut microbiota which may lead to disruption of the blood brain barrier, disruption to the gut-microbiome-brain axis and neurological symptoms. Additional testing, eradication of infectious agents as well as restoration of the gut microbiome are needed to effectively treat this condition.

Keywords: SARS-CoV-2; Coronavirus disease; Infection; Microbiome; Tourette’s