TY - JOUR

T1 - Neurological Complications in COVID-19 Patients

T2 - Can Analysis of Specific Antibodies and Viral RNA in Paired Cerebrospinal Fluid and Serum be Used for Accurate Diagnosis of SARS-CoV-2 Neuroinflammatory Disease? A Case Series

AU - Lauridsen, Karin Holst

AU - Olsen, Kristine Boisen

AU - Lund, Eva Løbner

AU - Jensen, Tomas O.

AU - Pedersen, Thomas Ingemann

AU - Harboe, Zitta Barrella

AU - Antsupova, Valeria

AU - Rasmussen, Lasse Dam

AU - Röser, Dennis

AU - Banner, Jytte

AU - Franck, Kristina Træholt

AU - Vorobieva Solholm Jensen, Veronika

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: All authors were funded by their individual departments. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

PY - 2022

Y1 - 2022

N2 - Background: Neurological complications during and after SARS-CoV-2 infection have been frequently described. The detection of either SARS-CoV-2 RNA or specific antibodies against SARS-CoV-2 in cerebrospinal fluid in the context of concomitant neurological manifestations indicates neuroinfection. Methods and Results: This is a retrospective descriptive analysis of cerebrospinal fluids and serum samples from 2 hospitalized patients and autopsy findings from 2 patients who died at home. Samples were analysed by 3 independent enzyme-linked immunosorbent assays. Specific antibodies against SARS-CoV-2 were detected in cerebrospinal fluids and paired serum in all 4 cases. Levels of antibodies in cerebrospinal fluids were highest in samples from a deceased man with critical progression of COVID-19 and detectable SARS-CoV-2 viral RNA in cerebrospinal fluid, serum, 4 brain biopsies and 15 additional tissue samples, though immunohistochemical staining for SARS-CoV-2 in brain tissue did not detect the virus. Conclusion: Detection of SARS-CoV-2 antibodies in paired serum and cerebrospinal fluid may support the presence of SARS-CoV-2 neuroinflammatory disease in patients with COVID-19 and neurological manifestations.

AB - Background: Neurological complications during and after SARS-CoV-2 infection have been frequently described. The detection of either SARS-CoV-2 RNA or specific antibodies against SARS-CoV-2 in cerebrospinal fluid in the context of concomitant neurological manifestations indicates neuroinfection. Methods and Results: This is a retrospective descriptive analysis of cerebrospinal fluids and serum samples from 2 hospitalized patients and autopsy findings from 2 patients who died at home. Samples were analysed by 3 independent enzyme-linked immunosorbent assays. Specific antibodies against SARS-CoV-2 were detected in cerebrospinal fluids and paired serum in all 4 cases. Levels of antibodies in cerebrospinal fluids were highest in samples from a deceased man with critical progression of COVID-19 and detectable SARS-CoV-2 viral RNA in cerebrospinal fluid, serum, 4 brain biopsies and 15 additional tissue samples, though immunohistochemical staining for SARS-CoV-2 in brain tissue did not detect the virus. Conclusion: Detection of SARS-CoV-2 antibodies in paired serum and cerebrospinal fluid may support the presence of SARS-CoV-2 neuroinflammatory disease in patients with COVID-19 and neurological manifestations.

KW - Antibodies

KW - autopsy

KW - case reports

KW - coronavirus

KW - immunohistochemistry

KW - SARS virus

U2 - 10.1177/2632010X221139096

DO - 10.1177/2632010X221139096

M3 - Journal article

C2 - 36448025

AN - SCOPUS:85142762469

VL - 15

SP - 1

EP - 7

JO - Clinical Pathology

JF - Clinical Pathology

SN - 2632-010X

ER -