Antibody Responses to Severe Acute Respiratory Syndrome Coronavirus 2 in the Serum and Cerebrospinal Fluid of Patients With Coronavirus Disease 2019 and Neurological Symptoms

Abstract Antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in serum and cerebrospinal fluid (CSF) samples from 16 patients with coronavirus disease 2019 and neurological symptoms were assessed using 2 independent methods. Immunoglobulin G (IgG) specific for the virus spike protein was found in 81% of patients in serum and in 56% in CSF. SARS-CoV-2 IgG in CSF was observed in 2 patients with negative serological findings. Levels of IgG in both serum and CSF were associated with disease severity (P < .05). All patients with elevated markers of central nervous system damage in CSF also had CSF antibodies (P = .002), and CSF antibodies had the highest predictive value for neuronal damage markers of all tested clinical variables.

[1]  C. O. Brandão,et al.  Cerebrospinal fluid findings in neurological diseases associated with COVID-19 and insights into mechanisms of disease development , 2020, International Journal of Infectious Diseases.

[2]  Anand Kumar,et al.  Reader Response: CSF Biomarkers in Patients With COVID-19 and Neurologic Symptoms: A Case Series , 2020, Neurology.

[3]  C. Wallace,et al.  Antibody responses to SARS-CoV-2 train machine learning to assign likelihood of past infection during virus emergence in Sweden , 2020 .

[4]  J. Gostner,et al.  CSF Biomarkers in Patients With COVID-19 and Neurologic Symptoms , 2020, Neurology.

[5]  H. Kamel,et al.  Effects of COVID-19 on the Nervous System , 2020, Cell.

[6]  M. Schibler,et al.  Cerebrospinal fluid features in SARS-CoV-2 RT-PCR positive patients , 2020, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[7]  J. Bergquist,et al.  Acute necrotizing encephalopathy with SARS-CoV-2 RNA confirmed in cerebrospinal fluid , 2020, Neurology.

[8]  K. Blennow,et al.  Neurochemical evidence of astrocytic and neuronal injury commonly found in COVID-19 , 2020, Neurology.

[9]  S. Castelain,et al.  COVID-19 encephalopathy: detection of antibodies against SARS-CoV-2 in CSF , 2020, Journal of Neurology.

[10]  William T. Hu,et al.  Encephalopathy and Encephalitis Associated with Cerebrospinal Fluid Cytokine Alterations and Coronavirus Disease, Atlanta, Georgia, USA, 2020 , 2020, Emerging infectious diseases.

[11]  N. Enomoto,et al.  A first case of meningitis/encephalitis associated with SARS-Coronavirus-2 , 2020, International Journal of Infectious Diseases.

[12]  B. Graham,et al.  Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation , 2020, Science.

[13]  P. Calabresi,et al.  A new enzyme-linked immunosorbent assay for neurofilament light in cerebrospinal fluid: analytical validation and clinical evaluation , 2018, Alzheimer's Research & Therapy.

[14]  Henrik,et al.  Biomarkers for CNS injury in CSF are elevated in COVID-19 and associated with neurological symptoms and disease severity , 2020 .