CSF and BLOOD ANALYSES in PARTICIPANTS with POST-COVID-19 NEUROPSYCHIATRIC SYMPTOMS
Topics in Antiviral Medicine
; 30(1 SUPPL):249, 2022.
Article
in English
| EMBASE | ID: covidwho-1880566
ABSTRACT
Background:
The pathogenesis of neuropsychiatric symptoms persisting months after acute SARS-CoV-2 infection is poorly understood. We examined clinical and laboratory parameters in participants with post-acute COVID-19 neuropsychiatric symptom to assess for systemic and nervous system immune perturbations.Methods:
Participants with a history of laboratory confirmed COVID-19 and ongoing neurologic symptoms were enrolled in an observational study that collected medical history;detailed post-COVID symptom survey;and paired cerebrospinal fluid (CSF) and blood. In addition to standard clinical labs, neopterin and anti-SARS-CoV-2 antibodies (anti-spike, RBD, and nucleocapsid) were measured by ELISA. Non-parametric tests were used to compare CSF and blood findings between the post-COVID participants and pre-COVID-19 era healthy controls.Results:
Post-COVID participants (n=27) and controls (n=21) were similar in age (median 51 and 46 years), but there was a greater proportion of females (67% vs 24%;p=0.004) and white participants in the post-COVID cohort (63% vs 24%;p=0.04). The post-COVID study visit was a median of 264 days (IQR 59-332) after acute COVID-19 symptom onset. 35% were hospitalized during their acute illness;12% required intensive care. 33% had previously been treated with medications for mental health conditions. The most frequent neuropsychiatric symptoms were cognitive impairment (67%), mood symptoms (67%), headache (56%), and neuropathy (41%). Blood c-reactive protein, T cell count, and T cell subset frequency (CD4% and CD8%) were similar between groups, while D-dimer was higher in the post-COVID cohort (median 0.48 vs 0.27 mg/L;p = 0.019) (Figure). CSF WBC, protein, neopterin, and CSF/blood albumin ratio were similar between the groups;the frequency of CSF lymphocytes was lower in the post-COVID cohort (p = 0.05) (Figure 1). Antibodies against at least one SARS-CoV-2 antigen were detected in 7/10 CSF and 8/9 blood samples in the post-COVID CSF (antibody reactivity range 1.5 to 55-fold greater than to control antigens).Conclusion:
In this small cohort of post-COVID participants with neurologic symptoms, we found limited differences in CSF and blood markers when compared to pre-pandemic healthy controls. Deeper immunophenotyping in a larger number of participants may provide greater insight into subtle differences. The presence of anti-SARS-CoV-2 antibodies in CSF months after acute infection warrants further investigation.
C reactive protein; CD4 antigen; CD8 antigen; D dimer; endogenous compound; neopterin; SARS-CoV-2 antibody; serum albumin; acute disease; adult; blood analysis; blood sampling; cell count; cerebrospinal fluid; clinical article; clinical laboratory; cognitive defect; cohort analysis; conference abstract; controlled study; coronavirus disease 2019; enzyme linked immunosorbent assay; female; gene frequency; headache; human; human cell; immunophenotyping; intensive care; long COVID; lymphocyte; medical history; mental disease; mental health; mood; neurologic disease; neuropathy; nonhuman; nonparametric test; observational study; pandemic; Severe acute respiratory syndrome coronavirus 2; spike; T lymphocyte; T lymphocyte subpopulation; virus nucleocapsid
Search on Google
Collection:
Databases of international organizations
Database:
EMBASE
Topics:
Long Covid
Language:
English
Journal:
Topics in Antiviral Medicine
Year:
2022
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS