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High Frequency of Autoantibodies in COVID-19 Patients with Central Nervous System Complications: a Multicenter Observational Study

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Abstract

We present a panel of central nervous system (CNS) complications associated with coronavirus disease 2019 (COVID-19) and their clinical characteristics. We aim to investigate associations between neurological autoantibodies and COVID-19 patients with predominant CNS complications. In this retrospective multi-center study, we analyze neurologic complications associated with COVID-19 patients from Dec. 2022 to Feb. 2023 at four tertiary hospitals in China. CSF and/or serum in the enrolled patients were tested for autoantibodies using tissue-based assays (TBAs) and cell-based assays (CBAs). A total of 34 consecutive patients (median age was 40.5 years [range 15–83], 50% were female) were enrolled. CNS syndromes included encephalitis (n=15), encephalopathies (n=6), meningoencephalitis (n=3), ADEM (n=2), depression (n = 2), Alzheimer’s disease (n=2), Parkinson disease (n=1), and central nervous system vasculitis (n=1). Twenty-eight specimens (of 44 tested; 11/27 [40.7%] CSF, 13/17 [76.5%] serums) were confirmed by TBAs to be autoantibodies positive. However, only a few autoantibodies (1 with MOG and 1 with NMDAR) were detected by CBAs assays. Twenty-four patients received immunotherapy. After a mean time of 7.26 months of follow-up, 75.8% (25/33) of patients had good outcome (mRS score ≤2). Although no significant difference was observed between the two groups, the proportion of positive CSF autoantibodies in the poor outcomes group was higher than that in the good outcomes group (57.1% vs 31.5%, P = 0.369). Autoantibodies were frequently observed in COVID-19-associated CNS complications. The identification of these autoantibody-positive COVID-19 cases is important as they respond favorably to immunotherapy.

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Data Availability

The data sets generated and/or analyzed during the current study are not publicly available but can be obtained by qualified researchers from the corresponding author on reasonable request.

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Acknowledgements

The authors thank all participants for their participation in our study.

Funding

Supported by the National Natural Science Foundation of China (grants 82371364).

Author information

Author notes

  1. Fudong Shi and Honghao Wang contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou, China

    Jingfang Lin & Honghao Wang

  2. Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China

    Dong Zheng

  3. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Decai Tian & Fudong Shi

  4. Center for Neurological Diseases, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Pei Zheng & Fudong Shi

  5. Department of Neurology, Shenzhen University General Hospital, Shenzhen, China

    Hongya Zhang

  6. Department of Neurology, Eight People’s Hospital of Guangzhou, Guangzhou, China

    Chuo Li

  7. Eight People’s Hospital of Guangzhou, Guangzhou, China

    Chunliang Lei

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  1. Jingfang Lin
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Contributions

Jingfang Lin accessed and verified the underlying data reported in the manuscript, literature search, data interpretation and writing; Dong Zheng, Decai Tian, Pei Zheng, Hongya Zhang, Chuo Li and Chunliang Lei carried out the figures, data collection and data analysis; Fudong Shi and Honghao Wang conceptualized and designed the study and revised the manuscript.

Corresponding author

Correspondence to Honghao Wang.

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Ethics Approval and Consent to Participate

The study was approved by the Ethics Committee of Eight people's Hospital of Guangzhou (202115202), Guangzhou. A written informed consent of each participant was obtained from their caregivers at admission prior to enrolment in the study.

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The authors declare no competing interests.

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Lin, J., Zheng, D., Tian, D. et al. High Frequency of Autoantibodies in COVID-19 Patients with Central Nervous System Complications: a Multicenter Observational Study. Mol Neurobiol (2024). https://doi.org/10.1007/s12035-024-04109-4

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