Neurological Complications in COVID-19 Patients: Can Analysis of Specific Antibodies and Viral RNA in Paired Cerebrospinal Fluid and Serum be Used for Accurate Diagnosis of SARS-CoV-2 Neuroinflammatory Disease? A Case Series

Karin Holst Lauridsen; Kristine Boisen Olsen; Eva Løbner Lund; Tomas O. Jensen; Thomas Ingemann Pedersen; Zitta Barrella Harboe; Valeria Antsupova; Lasse Dam Rasmussen; Dennis Röser; Jytte Banner; Kristina Træholt Franck; Veronika Vorobieva Solholm Jensen

doi:10.1177/2632010X221139096

Neurological Complications in COVID-19 Patients: Can Analysis of Specific Antibodies and Viral RNA in Paired Cerebrospinal Fluid and Serum be Used for Accurate Diagnosis of SARS-CoV-2 Neuroinflammatory Disease? A Case Series

Karin Holst Lauridsen^*, Kristine Boisen Olsen, Eva Løbner Lund, Tomas O. Jensen, Thomas Ingemann Pedersen, Zitta Barrella Harboe, Valeria Antsupova, Lasse Dam Rasmussen, Dennis Röser, Jytte Banner, Kristina Træholt Franck, Veronika Vorobieva Solholm Jensen

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › Research › peer-review

2 Citations (Scopus)

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Abstract

Background: Neurological complications during and after SARS-CoV-2 infection have been frequently described. The detection of either SARS-CoV-2 RNA or specific antibodies against SARS-CoV-2 in cerebrospinal fluid in the context of concomitant neurological manifestations indicates neuroinfection. Methods and Results: This is a retrospective descriptive analysis of cerebrospinal fluids and serum samples from 2 hospitalized patients and autopsy findings from 2 patients who died at home. Samples were analysed by 3 independent enzyme-linked immunosorbent assays. Specific antibodies against SARS-CoV-2 were detected in cerebrospinal fluids and paired serum in all 4 cases. Levels of antibodies in cerebrospinal fluids were highest in samples from a deceased man with critical progression of COVID-19 and detectable SARS-CoV-2 viral RNA in cerebrospinal fluid, serum, 4 brain biopsies and 15 additional tissue samples, though immunohistochemical staining for SARS-CoV-2 in brain tissue did not detect the virus. Conclusion: Detection of SARS-CoV-2 antibodies in paired serum and cerebrospinal fluid may support the presence of SARS-CoV-2 neuroinflammatory disease in patients with COVID-19 and neurological manifestations.

Original language	English
Journal	Clinical Pathology
Volume	15
Pages (from-to)	1-7
Number of pages	7
ISSN	2632-010X
DOIs	https://doi.org/10.1177/2632010X221139096
Publication status	Published - 2022

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: All authors were funded by their individual departments. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Keywords

Antibodies
autopsy
case reports
coronavirus
immunohistochemistry
SARS virus

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10.1177/2632010X221139096Licence: CC BY-NC

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Cite this

Lauridsen, K. H., Olsen, K. B., Lund, E. L., Jensen, T. O., Pedersen, T. I., Harboe, Z. B., Antsupova, V., Rasmussen, L. D., Röser, D., Banner, J., Franck, K. T., & Vorobieva Solholm Jensen, V. (2022). Neurological Complications in COVID-19 Patients: Can Analysis of Specific Antibodies and Viral RNA in Paired Cerebrospinal Fluid and Serum be Used for Accurate Diagnosis of SARS-CoV-2 Neuroinflammatory Disease? A Case Series. Clinical Pathology, 15, 1-7. https://doi.org/10.1177/2632010X221139096

Neurological Complications in COVID-19 Patients: Can Analysis of Specific Antibodies and Viral RNA in Paired Cerebrospinal Fluid and Serum be Used for Accurate Diagnosis of SARS-CoV-2 Neuroinflammatory Disease? A Case Series. / Lauridsen, Karin Holst; Olsen, Kristine Boisen ; Lund, Eva Løbner et al.
In: Clinical Pathology, Vol. 15, 2022, p. 1-7.

Research output: Contribution to journal › Journal article › Research › peer-review

Lauridsen, KH, Olsen, KB , Lund, EL, Jensen, TO, Pedersen, TI, Harboe, ZB, Antsupova, V, Rasmussen, LD, Röser, D, Banner, J, Franck, KT & Vorobieva Solholm Jensen, V 2022, 'Neurological Complications in COVID-19 Patients: Can Analysis of Specific Antibodies and Viral RNA in Paired Cerebrospinal Fluid and Serum be Used for Accurate Diagnosis of SARS-CoV-2 Neuroinflammatory Disease? A Case Series', Clinical Pathology, vol. 15, pp. 1-7. https://doi.org/10.1177/2632010X221139096

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title = "Neurological Complications in COVID-19 Patients: Can Analysis of Specific Antibodies and Viral RNA in Paired Cerebrospinal Fluid and Serum be Used for Accurate Diagnosis of SARS-CoV-2 Neuroinflammatory Disease? A Case Series",

abstract = "Background: Neurological complications during and after SARS-CoV-2 infection have been frequently described. The detection of either SARS-CoV-2 RNA or specific antibodies against SARS-CoV-2 in cerebrospinal fluid in the context of concomitant neurological manifestations indicates neuroinfection. Methods and Results: This is a retrospective descriptive analysis of cerebrospinal fluids and serum samples from 2 hospitalized patients and autopsy findings from 2 patients who died at home. Samples were analysed by 3 independent enzyme-linked immunosorbent assays. Specific antibodies against SARS-CoV-2 were detected in cerebrospinal fluids and paired serum in all 4 cases. Levels of antibodies in cerebrospinal fluids were highest in samples from a deceased man with critical progression of COVID-19 and detectable SARS-CoV-2 viral RNA in cerebrospinal fluid, serum, 4 brain biopsies and 15 additional tissue samples, though immunohistochemical staining for SARS-CoV-2 in brain tissue did not detect the virus. Conclusion: Detection of SARS-CoV-2 antibodies in paired serum and cerebrospinal fluid may support the presence of SARS-CoV-2 neuroinflammatory disease in patients with COVID-19 and neurological manifestations.",

keywords = "Antibodies, autopsy, case reports, coronavirus, immunohistochemistry, SARS virus",

author = "Lauridsen, {Karin Holst} and Olsen, {Kristine Boisen} and Lund, {Eva L{\o}bner} and Jensen, {Tomas O.} and Pedersen, {Thomas Ingemann} and Harboe, {Zitta Barrella} and Valeria Antsupova and Rasmussen, {Lasse Dam} and Dennis R{\"o}ser and Jytte Banner and Franck, {Kristina Tr{\ae}holt} and {Vorobieva Solholm Jensen}, Veronika",

note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: All authors were funded by their individual departments. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. ",

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T2 - Can Analysis of Specific Antibodies and Viral RNA in Paired Cerebrospinal Fluid and Serum be Used for Accurate Diagnosis of SARS-CoV-2 Neuroinflammatory Disease? A Case Series

AU - Lauridsen, Karin Holst

AU - Olsen, Kristine Boisen

AU - Lund, Eva Løbner

AU - Jensen, Tomas O.

AU - Pedersen, Thomas Ingemann

AU - Harboe, Zitta Barrella

AU - Antsupova, Valeria

AU - Rasmussen, Lasse Dam

AU - Röser, Dennis

AU - Banner, Jytte

AU - Franck, Kristina Træholt

AU - Vorobieva Solholm Jensen, Veronika

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: All authors were funded by their individual departments. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

PY - 2022

Y1 - 2022

N2 - Background: Neurological complications during and after SARS-CoV-2 infection have been frequently described. The detection of either SARS-CoV-2 RNA or specific antibodies against SARS-CoV-2 in cerebrospinal fluid in the context of concomitant neurological manifestations indicates neuroinfection. Methods and Results: This is a retrospective descriptive analysis of cerebrospinal fluids and serum samples from 2 hospitalized patients and autopsy findings from 2 patients who died at home. Samples were analysed by 3 independent enzyme-linked immunosorbent assays. Specific antibodies against SARS-CoV-2 were detected in cerebrospinal fluids and paired serum in all 4 cases. Levels of antibodies in cerebrospinal fluids were highest in samples from a deceased man with critical progression of COVID-19 and detectable SARS-CoV-2 viral RNA in cerebrospinal fluid, serum, 4 brain biopsies and 15 additional tissue samples, though immunohistochemical staining for SARS-CoV-2 in brain tissue did not detect the virus. Conclusion: Detection of SARS-CoV-2 antibodies in paired serum and cerebrospinal fluid may support the presence of SARS-CoV-2 neuroinflammatory disease in patients with COVID-19 and neurological manifestations.

AB - Background: Neurological complications during and after SARS-CoV-2 infection have been frequently described. The detection of either SARS-CoV-2 RNA or specific antibodies against SARS-CoV-2 in cerebrospinal fluid in the context of concomitant neurological manifestations indicates neuroinfection. Methods and Results: This is a retrospective descriptive analysis of cerebrospinal fluids and serum samples from 2 hospitalized patients and autopsy findings from 2 patients who died at home. Samples were analysed by 3 independent enzyme-linked immunosorbent assays. Specific antibodies against SARS-CoV-2 were detected in cerebrospinal fluids and paired serum in all 4 cases. Levels of antibodies in cerebrospinal fluids were highest in samples from a deceased man with critical progression of COVID-19 and detectable SARS-CoV-2 viral RNA in cerebrospinal fluid, serum, 4 brain biopsies and 15 additional tissue samples, though immunohistochemical staining for SARS-CoV-2 in brain tissue did not detect the virus. Conclusion: Detection of SARS-CoV-2 antibodies in paired serum and cerebrospinal fluid may support the presence of SARS-CoV-2 neuroinflammatory disease in patients with COVID-19 and neurological manifestations.

KW - Antibodies

KW - autopsy

KW - case reports

KW - coronavirus

KW - immunohistochemistry

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DO - 10.1177/2632010X221139096

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