Immune-mediated pathogenesis and development of autoimmunity in neurological manifestations of COVID-19
Clinical Neurology; Neurosurgery and Neuroradiology
Final Report Abstract
We investigated neurological aspects of COVID-19 and post-COVID-19, and implemented neurological post-covid-19 outpatient clinics, recognized by local and national media (https://www.zdf.de/nachrichten/zdf-morgenmagazin/corona-post-covid-langzeitfolgencharite-100.html, https://www.ksta.de/ratgeber/gesundheit/diagnose-neuro-covid-ich-habe-gemerkt-dass-ich-ganz-vergesslich-wurde-38470876?cb=1644833205289&). In particular, severe physical and mental fatigue, as well as cognitive deficits are among the most frequent post-COVID-19 symptoms in our cohorts, currently being further investigated. Our experimental data suggest that neurological post-COVID-19 symptoms are most likely not explained by a persistent infection of the CNS with SARS-COV-2. In contrast, antineuronal autoantibodies might play a major role, which provides a starting point for more in-depth studies in the future. First data on autoimmune profiles of CSF/serum pairs obtained from these patients support an immune-mediated pathogenesis, at least in a fraction of the patients in correlation with pathological cognitive screening assessment. Follow-up analyses will clarify whether the here detected autoimmune reactivity can identify a subgroup of patients which may benefit from immunotherapies. Further studies are needed in particular in well-selected individuals with persistent cognitive impairment, and in patients fulfilling the criteria of autoimmune neurological diseases, diagnosed in close temporal association with COVID-19., or vaccination against COVID-19. This will be a focus of our suggested follow-up project.
Publications
- A Neurological Outpatient Clinic for Patients With Post-COVID-19 Syndrome - A Report on the Clinical Presentations of the First 100 Patients. Front Neurol. 2021;12:738405
Boesl F, Audebert H, Endres M, Prüss H, Franke C
(See online at https://doi.org/10.3389/fneur.2021.738405) - CSF analysis in post-COVID-19 is not suggestive of persistent CNS infection. Ann Neurol. 2021 Vov. 1
Schweitzer F, Goereci Y, Franke C, Silling S, Bösl F, Maier F, Heger E, Deiman B, Prüss H, Onur OA, Klein F, Fink G, Di Cristanziano V, Warnke C
(See online at https://doi.org/10.1002/ana.26262) - Neuro-COVID-19 is more than anosmia: clinical presentation, neurodiagnostics, therapies, and prognosis. Curr Opin Neurol. 2021; 34(3): 423-431
Schweitzer F, Kleineberg N, Goereci Y, Onur OA, Franke C, Warnke C
(See online at https://doi.org/10.1097/wco.0000000000000930)
