Retrospective screening of anti-SARS-CoV-2 antibodies in cerebrospinal fluid samples of patients with neurological manifestations of unknown etiology in a tertiary care hospital during the pandemic period (preprint)

ABSTRACT

Since the onset of the pandemic, neurological manifestations of COVID-19 are increasingly being reported in the scientific literature. However, since these manifestations are not the primary symptoms, SARS-CoV-2 is not being considered the etiological agent in most cases. The primary objective of this study was to screen for anti-SARS-CoV-2 antibodies in cerebrospinal fluid (CSF) of patients with neurological manifestations of undiscerned etiology and correlate the antibody levels with the clinical characteristics, derangement in blood & CSF biochemical parameters, comorbidities, radiological findings and prognosis. CSF samples of clinically suspected encephalitis cases of unknown etiology, during the pandemic period (January 2021 to April 2022) were included in the study. Patients were categorised into two groups based on the presence or absence of anti-SARS-CoV-2 antibodies (IgG and IgM) in the CSF. Statistical analysis was done using IBM SPSS Statistics (Version 20.0) software. Out of 112 samples tested, 89 samples had IgG antibodies and three samples had both IgM and IgG antibodies against SARS-CoV-2 virus. Viral nucleic acid could not be detected in any of the tested CSF samples. Altered sensorium and fever were found to be the most significant clinical symptoms associated with the presence of anti-SARS-CoV-2 antibodies in the CSF. An increase in CSF biochemical parameters like glucose, protein, white blood cells along with blood biochemical parameters like serum albumin, alanine transaminase and C - reactive protein was seen in patients who had anti-SARS-CoV-2 antibodies in the CSF. Statistically, no significant correlation was found between the presence of anti-SARS-CoV-2 IgG antibodies and the clinical and biochemical parameters in both groups of patients.