Anti-SARS-CoV-2 and Autoantibody Profiles in the Cerebrospinal Fluid of 3 Teenaged Patients With COVID-19 and Subacute Neuropsychiatric Symptoms.
JAMA Neurol
; 78(12): 1503-1509, 2021 12 01.
Article
in English
| MEDLINE | ID: covidwho-1482083
ABSTRACT
Importance Neuropsychiatric manifestations of COVID-19 have been reported in the pediatric population. Objective:
To determine whether anti-SARS-CoV-2 and autoreactive antibodies are present in the cerebrospinal fluid (CSF) of pediatric patients with COVID-19 and subacute neuropsychiatric dysfunction. Design, Setting, andParticipants:
This case series includes 3 patients with recent SARS-CoV-2 infection as confirmed by reverse transcriptase-polymerase chain reaction or IgG serology with recent exposure history who were hospitalized at the University of California, San Francisco Benioff Children's Hospital and for whom a neurology consultation was requested over a 5-month period in 2020. During this period, 18 total children were hospitalized and tested positive for acute SARS-CoV-2 infection by reverse transcriptase-polymerase chain reaction or rapid antigen test. Main Outcomes andMeasures:
Detection and characterization of CSF anti-SARS-CoV-2 IgG and antineural antibodies.Results:
Of 3 included teenaged patients, 2 patients had intrathecal anti-SARS-CoV-2 antibodies. CSF IgG from these 2 patients also indicated antineural autoantibodies on anatomic immunostaining. Autoantibodies targeting transcription factor 4 (TCF4) in 1 patient who appeared to have a robust response to immunotherapy were also validated. Conclusions and Relevance Pediatric patients with COVID-19 and prominent subacute neuropsychiatric symptoms, ranging from severe anxiety to delusional psychosis, may have anti-SARS-CoV-2 and antineural antibodies in their CSF and may respond to immunotherapy.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Autoantibodies
/
COVID-19
/
Mental Disorders
/
Antibodies, Viral
/
Nervous System Diseases
Type of study:
Case report
/
Prognostic study
/
Qualitative research
Topics:
Long Covid
Limits:
Adolescent
/
Animals
/
Female
/
Humans
/
Male
Language:
English
Journal:
JAMA Neurol
Year:
2021
Document Type:
Article
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