NEW YORK (Reuters Health) – SARS-CoV-2 viral antigens may contribute to central nervous system (CNS) immune responses without direct viral invasion of the CNS, new data suggest.
It’s now known that patients with COVID-19 may develop neurologic symptoms but it’s unclear why, as SARS-CoV-2 RNA is rarely detected in cerebrospinal fluid (CSF).
In a cross-sectional study of 44 patients with COVID-19 (23 with neurologic symptoms), researchers detected SARS-CoV-2 nucleocapsid antigen (N-Ag) in CSF in 89% of patients with available data, despite negative viral RNA test results in all patients.
N-Ag was significantly correlated with immune activation markers (neopterin and gamma interferon), report Dr. Arvid Eden, with Sahlgrenska Academy, University of Gothenburg, Sweden, and colleagues in JAMA Network Open.
Moreover, COVID-19 patients with neurologic symptoms had a more pronounced inflammatory CSF profile compared with peers without neurologic symptoms, “suggesting that the magnitude of the CNS immune response, possibly triggered by viral components, contributes to the neuropathogenesis of COVID-19,” they say.
“These observations could not be attributed to differences in COVID-19 severity, where no differences in CSF biomarkers were seen in patients with moderate compared with severe disease,” they note.
“These findings have important potential implications for clinical treatment of patients with COVID-19, including the use of antiviral therapies, as well as for the continued importance of including CSF analyses in future studies of CNS pathogenesis and treatment strategies,” the researchers add.
SOURCE: https://bit.ly/3lBa4j7 JAMA Network Open, online May 23, 2022.
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