Novel coronavirus (SARS-CoV-2) emerged in Wuhan, China, and it most commonly presents with respiratory symptoms ranging from cough, low-grade fever to severe pneumonia. Neurological complications of COVID-19 remain largely unfamiliar and sometimes the unique initial presenting complaint of COVID-19. We reported the first unique presentation of SARS—CoV-2 virus in a 21-years-old medical student, who presented with initial signs and symptoms of meningitis and later on developed respiratory symptoms on the second day of admission. An extensive work-up was done to evaluate the cause of meningitis, the results of which were unremarkable (Table 1). As per hospital protocol and based on respiratory symptoms, a nasopharyngeal swab for SARS-CoV-2 was sent, the result of which came out positive. He was labeled as a case of meningitis secondary to probably SARS-CoV-2 infection, as no other causative factor was found. His condition deteriorated and unfortunately, he died because of multi-organ failure. Conclusion: The SARS-CoV-2 virus can cause neurological manifestations by various proposed mechanisms. It can spread to the braindirectly through angiotensin-converting enzyme receptors 2 or it can affect the brain through hematogenous spread or neuronal pathway. As these neurological manifestations are fatal, a physician should keep in mind all these manifestations, while encountering patients, especially during this pandemic. Early diagnosis can have a good outcome for the patients as well as we can prevent the vertical spread of this virus by taking precautionary measures.
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