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Clin Pathol
. 2022 Nov 26;15:2632010X221139096.
doi: 10.1177/2632010X221139096. eCollection 2022 Jan-Dec.
Neurological Complications in COVID-19 Patients: 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
Karin Holst Lauridsen 1 , Kristine Boisen Olsen 2 , Eva Løbner Lund 3 , Tomas O Jensen 1 4 , Thomas Ingemann Pedersen 1 , Zitta Barrella Harboe 1 5 , Valeria Antsupova 6 , Lasse Dam Rasmussen 7 , Dennis Röser 8 , Jytte Banner 2 , Kristina Træholt Franck 7 , Veronika Vorobieva Solholm Jensen 7
Affiliations
- PMID: 36448025
- PMCID: PMC9702593
- DOI: 10.1177/2632010X221139096
Abstract
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.
Keywords: Antibodies; SARS virus; autopsy; case reports; coronavirus; immunohistochemistry.