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Clin Pathol . Neurological Complications in COVID-19 Patients: Can Analysis of Specific Antibodies and Viral RNA in Paired Cerebrospinal Fluid and

tetano

Editor, Senior Moderator
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[SUP] 1 [/SUP], Kristine Boisen Olsen[SUP] 2 [/SUP], Eva Løbner Lund[SUP] 3 [/SUP], Tomas O Jensen[SUP] 1 4 [/SUP], Thomas Ingemann Pedersen[SUP] 1 [/SUP], Zitta Barrella Harboe[SUP] 1 5 [/SUP], Valeria Antsupova[SUP] 6 [/SUP], Lasse Dam Rasmussen[SUP] 7 [/SUP], Dennis Röser[SUP] 8 [/SUP], Jytte Banner[SUP] 2 [/SUP], Kristina Træholt Franck[SUP] 7 [/SUP], Veronika Vorobieva Solholm Jensen[SUP] 7 [/SUP]



Affiliations

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.
 
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