ABSTRACT
Here, we describe the clinical phenotype of SARS-CoV-2-related CNS disease and evaluate the SARS-CoV-2 antibody index as a tool to differentiate between a direct (viral) and indirect etiology. Out of >4000 hospitalized patients with COVID-19, we included 13 patients with neurological symptoms with suspicion of neuroinflammation. On clinical grounds, eight were classified as having a possible/probable relationship between neurological symptoms and COVID-19. A clinically distinctive phenotype of brainstem and cerebellar symptoms was seen in 6/8 patients. As we found a positive SARS-CoV-2 antibody index in 3/5 patients, indicating specific intrathecal SARS-CoV-2 IgG production, a direct link with SARS-CoV-2 is likely. Graphical AI: antibody index, CBA: cell-based assay, CNS: central nervous system, COVID-19: coronavirus disease 2019, CSF: cerebrospinal fluid, HSV: herpes simplex virus, IHC: immunohistochemistry, PCR: polymerase chain reaction, SARS-CoV-2: severe acute respiratory syndrome coronavirus 2.Unlabelled Image