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SARS-CoV-2 antibodies in inflammatory neurological conditions: a multicentre retrospective comparative study

Abstract:

It is well established that neurological and non-neurological autoimmune disorders can be triggered by viral infections. It remains unclear whether SARS-CoV-2 infection induces similar conditions and whether they show a distinctive phenotype. We retrospectively identified patients with acute inflammatory CNS conditions referred to our laboratory for antibody testing during the pandemic (March 1 to August 31, 2020). We screened SARS-COV-2 IgA/IgG in all sera by ELISA and confirmed the positivity with additional assays. Clinical and paraclinical data of SARS-COV-2-IgG seropositive patients were compared to those of seronegative cases matched for clinical phenotype, geographical zone, and timeframe. SARS-CoV-2-IgG positivity was detected in 16/339 (4%) sera, with paired CSF positivity in 3/16. 5 of these patients had atypical demyelinating disorders and 11 autoimmune encephalitis syndromes. 9/16 patients had a previous history of SARS-CoV-2 infection and 6 of them were symptomatic. In comparison with 32 consecutive seronegative controls, SARS-CoV-2-IgG-positive patients were older, frequently presented with encephalopathy, had lower rates of CSF pleocytosis and other neurological autoantibodies, and were less likely to receive immunotherapy. When SARS-CoV-2 seropositive versus seronegative cases with demyelinating disorders were compared no differences were seen. Whereas seropositive encephalitis patients less commonly showed increased CSF cells and protein, our data suggest that an antecedent symptomatic or asymptomatic SARS-CoV-2 infection can be detected in patients with autoimmune neurological conditions. These cases are rare, usually do not have specific neuroglial antibodies.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1007/s12026-023-09384-2

Authors


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Role:
Author
ORCID:
0000-0002-3249-4792
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Institution:
University of Oxford
Division:
MSD
Department:
Clinical Neurosciences
Oxford college:
Corpus Christi College
Role:
Author
ORCID:
0000-0002-7667-9748
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Role:
Author
ORCID:
0000-0003-2029-6606


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Funder identifier:
https://ror.org/039bp8j42


Publisher:
Springer
Journal:
Immunologic Research More from this journal
Volume:
71
Issue:
5
Pages:
717-724
Publication date:
2023-05-12
Acceptance date:
2023-04-18
DOI:
EISSN:
1559-0755
ISSN:
0257-277X
Pmid:
37171542


Language:
English
Keywords:
Pubs id:
1347000
Local pid:
pubs:1347000
Deposit date:
2025-02-07

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